| Theme | The multifaced role of bone for multisystem illness | |
|---|---|---|
| Title | Kidney, bone and CKD-MBD | |
| Publish Date | 2014/04 | |
| Author | Hiroo Takahashi | Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| Author | Takatoshi Kakuta | Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| Author | Masafumi Fukagawa | Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| [ Summary ] | The kidneys play an important role in mineral metabolism. In addition to being a target organ for various hormones involved in calcium and phosphorus metabolism, the kidneys are the primary organ activating vitamin D. SHPT is a common complication of CKD, characterized by persistently elevated levels of PTH and parathyroid hyperplasia. It develops early in the course of CKD as an adaptive response to altered mineral homeostasis due to decreased kidney function, i.e., hyperphosphatemia, hypocalcemia, and 1,25(OH)2D deficiency. In the last decade, it has become widely accepted that improper mineral metabolism in patients with CKD results not only in association with bone disease, but also a higher risk of cardiovascular disease and reduced survival rates, through the development of vascular calcification. This has led to a proposal for a new concept, termed "CKD-mineral and bone disorder". CKD-MBD is a systemic condition that manifests as abnormalities in PTH, calcium, phosphorus and vitamin D levels, bone abnormalities and extraskeletal calcification. Because this is a systemic disease, management of these abnormalities should ultimately be aimed at reducing the risk of cardiovascular events, bone fractures and extending survival rates. |
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