| Theme |
Parathyroid diseases and their pathogenesis |
| Title |
The relationship between renal bone disease and phosphate-regulating hormones in patients with chronic kidney disease |
| Author |
Aiji Yajima |
Department of Pathology, The University of Texas, Southwestern Medical Center at Dallas / Division of Renal Replacement of Therapeutic Science, Akita University / Department of Nephrology and Urology, Akebono Clinic |
| Author |
Makoto Kuro-o |
Department of Pathology, The University of Texas, Southwestern Medical Center at Dallas |
| Author |
Masaaki Inaba |
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine |
| Author |
Yasuo Imanishi |
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine |
| Author |
Yoshihiro Tominaga |
Department of Endocrine Surgery, Nagoya Second Red Cross Hospital |
| Author |
Kosaku Nitta |
Department of Medicine, Kidney Center, Tokyo Women's Medical University |
| Author |
Motoko Tanaka |
Department of Nephrology, Akebono Clinic |
| Author |
Kazunori Matsushita |
Department of Orthopedic Surgery, Akebono Clinic |
| Author |
Kazutaka Matsushita |
Department of Nephrology and Urology, Akebono Clinic |
| Author |
Shigeru Satoh |
Division of Renal Replacement of Therapeutic Science, Akita University |
| Author |
Akemi Ito |
Ito Bone Histomorphometry Institute |
| [ Summary ] |
Klotho deficiency and FGF-23 increase followed by vitamin D decrease and PTH increase are closely associated with the development of CKD-MBD. These changes are regarded as an attempt to maintain phosphorus homeostasis with reduced functional nephron number. Renal bone disease is characterized by reduced bone volume, increased woven texture of bone and microcrack, which potentially lead to bone pain and fragile bone. Various kinds of vitamin D compounds and/or calcimimetic agents have been used for the treatment of renal hyperparathyroidism, however, parathyroidectomy is often more effective for patients refractory to conservative therapy with high turnover bone disease. Post-parathyroidectomy management is also very important for the improvement of high bone turnover. In this review paper, recent progresses in basic and clinical studies and unsolved problems in CKD-MBD are discussed. |