Published in:
01-06-2009 | Guidelines
Chapter 22. Disorder of mineral and bone metabolism in CKD
Published in: Clinical and Experimental Nephrology | Issue 3/2009
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Patients with CKD develop mineral metabolism disorder, which is called CKD mineral and bone disorder (CKD-MBD), including not only bone disorder, but also systemic disease affecting life expectancy through vascular calcification.
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Development of CKD-MBD is caused by complicated mechanisms such as secondary hyperparathyroidism and impaired mineralization and matrix formation of the bone.
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As CKD progresses, serum calcium (Ca) concentration decreases, whereas serum phosphate (P) and parathyroid hormone (PTH) concentrations increase (that is secondary hyperparathyroidism).
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In CKD-MBD, serum Ca and P concentrations are measured at every visit. Serum Ca concentration needs to be corrected if hypoalbuminemia exists.
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In CKD stages 3–5, serum PTH is measured at least once a year. If it is found out of an optimal range, consultation with nephrologists is recommended.
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In CKD stages 3–5, administration of active vitamin D and calcium regimens used for osteoporosis may be reduced in dose.