| [ Summary ] |
Chronic kidney disease-mineral and bone disorders (CKD-MBD) often develops in early stage patients. The pathogenesis of this condition, including the role of fibroblast growth factor 23 (FGF23) is gradually being recognized. In regard to CKD-MBD treatment, it is important to manage serum phosphorus level within normal ranges through dietary phosphorus restriction, especially inorganic phosphates which are more readily absorbed by the intestines with the use of phosphate binders. Calcium carbonate reduces serum phosphorus levels and corrects hypocalcemia. However, it is possible that calcium carbonate induces ectopic calcification by combining with vitamin D receptor activators (VDRA). Non-classical effects of vitamin D such as improving survival and protection of renal function are observed. Nevertheless, it is recommended that VDRAs be used for the practical purpose of reducing PTH levels. |