Chronic kidney disease–mineral and bone disorder
| Chronic kidney disease–mineral and bone disorder | |
|---|---|
| Specialty | Nephrology |
Chronic kidney disease–mineral and bone disorder (CKD–MBD) is one of the many complications associated with chronic kidney disease. It represents a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of the following:[1][2]
- Abnormalities of calcium, phosphorus (phosphate), parathyroid hormone, or vitamin D metabolism
- Abnormalities in bone turnover, mineralization, volume, linear growth, or strength
- Vascular or other soft-tissue calcification
CKD–MBD explains, at least in part, the high morbidity and mortality of CKD patients, linking kidney and bone disease with cardiovascular complications. It is a matter of discussion whether CKD–MBD may be considered a real syndrome or not.[3]
CKD–MBD broadens the "old" concept of "renal osteodystrophy", which now should be restricted to describing the bone pathology associated with CKD.[1][2] Thus, renal osteodystrophy is currently considered one measure of the skeletal component of the systemic disorder of CKD–MBD that is quantifiable by histomorphometry of bone biopsy.[1][4] New guidelines have been recently released.[5]
- ^ a b c Moe S, Drueke T, Cunningham J (2006). "Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO)". Kidney International. 69 (11): 1945–53. doi:10.1038/sj.ki.5000414. PMID 16641930.
- ^ a b KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) (2009). "Introduction and definition of CKD–MBD and the development of the guideline statements". Kidney International Supplements. 76 (Suppl 113): S3 – S8. doi:10.1038/ki.2009.189. PMID 26746396.
- ^ Cozzolino M, Ureña-Torres P, Vervloet MG, Brandenburg V, Bover J, Goldsmith D, Larsson TE, Massy ZA, Mazzaferro S, CKD-MBD Working Group of ERA-EDTA (2014). "Is chronic kidney disease-mineral bone disorder (CKD-MBD) really a syndrome?". Nephrol Dial Transplant. 29 (10): 1815–20. doi:10.1093/ndt/gft514. hdl:2434/230560. PMID 24516228.
- ^ Torres PU, Bover J, Mazzaferro S, de Vernejoul MC, Cohen-Solal M (2014). "When, how, and why a bone biopsy should be performed in patients with chronic kidney disease". Semin Nephrol. 34 (6): 612–25. doi:10.1016/j.semnephrol.2014.09.004. PMID 25498380.
- ^ "KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)" (PDF). Kidney International Supplements. 7 (1): 1–59. July 2017. doi:10.1016/j.kisu.2017.04.001. PMC 6340919. PMID 30675420.