International Journal of Nephrology and Renovascular Disease (Dec 2019)
Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD): Current Perspectives
Abstract
Bala Waziri,1,2 Raquel Duarte,1 Saraladevi Naicker1 1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Department of Medicine, Ibrahim Badamasi Babangida Specialist Hospital, Minna, NigeriaCorrespondence: Bala WaziriDepartment of Medicine, Ibrahim Badamasi Babangida Specialist Hospital, Km 10, Paiko Road, Minna, NigeriaEmail [email protected]: Despite the availability of global and regional guidelines to curtail the adverse clinical outcomes associated with chronic kidney disease–mineral and bone disorder (CKD-MBD), most CKD patients are still affected by the consequences of abnormalities of CKD-MBD. This important clinical complication of CKD continues to be studied, in order to improve the understanding and management of CKD-MBD. Some notable discoveries include the role of fibroblast growth factor 23 (FGF23) in the pathogenesis of CKD-MBD, leading to a shift from the previous well-established classic trade-off hypothesis to the updated trade-off hypothesis. More recently, there has been a shift from the treatment of CKD-MBD based on a single level of biomarkers to serial measurements of calcium, phosphate and parathyroid hormone (PTH). Furthermore, some clinical trials have emerged after the 2009 Kidney Disease-Improving Global Outcomes (KDIGO) Guidelines, leading to the 2017 KDIGO updated recommendations. Hence, this review gives an overview of the rapidly evolving trends in CKD-MBD, linking the past and current concepts of CKD-MBD.Keywords: chronic kidney disease–mineral and bone disorder, updated pathogenesis, emerging trends, management
