| Theme |
The appropriate management for CKD-MBD in the elderly patients |
| Title |
How to think about bone disease associated with chronic kidney disease |
| Author |
Aiji Yajima |
Indiana University, School of Medicine, Department of Anatomy and Cell Biology / Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| Author |
Ken Tsuchiya |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| Author |
Kosaku Nitta |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| [ Summary ] |
The diagnosis, treatment and research of bone disease associated with chronic kidney disease have progressed significantly in the past 20 years. The determinants of the extent of renal bone disease are parathyroid hormone, vitamin D, and sex steroid hormone levels. Sclerostin is also an important factor when considering the extent of bone disease. The development of vitamin D analogues, the use of calcimimetic agents, and parathyroidectomy are all important treatments for hyperparathyroid bone disease. Lanthanum-containing phosphate binder is quite effective in repairing microcracks in low turnover bone disease, because it increases mineralization by the osteocytes in deep bone, including the basic multicellular unit. Moreover, sex steroid hormone levels are important regulators of the disease. Thus, we should consider the importance of estrogen and stimulation of the estrogen receptor on the osteocyte to treat renal bone disease. |