| Theme |
How Should We Step up the Future Dialysis Therapy in Japan ? |
| Title |
Management for chronic kidney disease-mineral and bone disorder |
| Author |
Takatoshi Kakuta |
Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine |
| [ Summary ] |
The concept of bone disease in dialysis patient has shifted from ROD to CKD-MBD as a systemic disease. Coronary artery calcification often occurs in dialysis patients and is predictive of cardiovascular morbidity and mortality in end-stage renal disease (ESRD) patients. Disturbed mineral metabolism assumes particular importance in vascular calcification in ESRD patients. Increased serum phosphorus and calcium, and calcium×phosphorus product in dialysis patients are independently associated with an increased risk of arterial calcification and of cardiovascular mortality. Kidney Disease : Improving Global Outcomes (KDIGO) proposed a pathologic model for CKD-mineral and bone disorder (CKD-MBD). A pathologic model for CKD-MBD and CKD-related bone diseases is proposed. |