77. Pathophysiology of Chronic Kidney Disease Mineral Bone Disorder (CKD-MBD)

  1. Clifford J. Rosen MD
  1. Keith A. Hruska and
  2. Michael Seifert

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch77

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Hruska, K. A. and Seifert, M. (2013) Pathophysiology of Chronic Kidney Disease Mineral Bone Disorder (CKD-MBD), in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch77

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • chronic kidney disease (CKD);
  • mineral bone disorder (MBD);
  • pathophysiology;
  • renal osteodystrophy (ROD)

Summary

This chapter talks about pathophysiology of chronic kidney disease mineral bone disorder (CKD-MBD). It discusses the pathogenetic factors such as fibroblast growth factor 23 (FGF23), Klotho, and hyperphosphatemia in the CKD-MBD. Depending on the relative contribution of the different pathogenic factors and their treatment, various pathologic patterns of bone remodeling are expressed in CKD and end-stage kidney disease (ESKD). Renal injury disturbs the complex physiology of bone and mineral metabolism, promotes vascular calcification, and compromises cardiac function. In addition, the effects of kidney disease on the skeleton contribute through the bone-cardiovascular axes to the major effect of kidney injury to stimulate cardiovascular disease and produce the high mortality rates associated with kidney disease. The pandemic of CKD and ESKD and the role of the CKD—MBD in the associated mortality, make the syndrome a major health issue for Americans and all developed societies.