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Chronic Kidney Disease—Mineral and Bone Disorders: Pathogenesis and Management

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Abstract

The key players of the chronic kidney disease-mineral and bone disorders (CKD-MBD) are calcium, phosphate, PTH, FGF23, and the vitamin D hormonal system. The progressive reduction of kidney function greatly modifies the tightly interrelated mechanisms that control these parameters. As a result, important changes occur in the bone and mineral hormonal axis, leading to changes in bone turnover with relevant consequences in clinical outcomes, such as decrease in bone mass with increased bone fragility and bone fractures and increased vascular and valvular calcification, also with great impact in the cardiovascular outcomes. So far, the knowledge of the mineral and bone disorders in CKD and the increased variety of efficacious therapies should lead to a better prevention and management of CKD-MBD.

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Fig. 1

Modified from Cannata-Andía et al. [6], A clinician’s guide with permission from Springer, Copyright © 2014.)

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MacMillan Publishers Ltd: Levin et al. [21], Copyright © 2007.)

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Acknowledgements

The authors wish to thank Instituto de Salud Carlos III (ISCIII; PI16/00637 and PI19/00532), the ISCIII Retic REDinREN (RD06/0016/1013, RD12/0021/0023, RD16/0009/0017 and RD16/0009/0021), Fondo Europeo de Desarrollo Regional (FEDER), Plan Estatal de I+D+I 2013-2016, Plan de Ciencia, Tecnología e Innovación 2013-2017 y 2018-2022 del Principado de Asturias (GRUPIN14-028, IDI-2018-000152), Fundación Renal Iñigo Álvarez de Toledo (FRIAT), and University of Oviedo. B.M.C. was supporting by a graduate fellowship from the Gobierno del Principado de Asturias (“Severo Ochoa” program), J.M.V. by a graduate fellowship from the Ministerio de Ciencia, Innovación y Universidades (FPU program), J.R.C. by postdoctoral contracts from the “Juan de la Cierva” (IJCI-2017-32070, Ministerio de Ciencia e Innovación, Spain) and “Sara Borrell” programs (CD19/00120, from ISCIII), C.A.M. by REDinREN-FINBA (RD16/0009/0017) and N.C.L. has been supported by FINBA-GRUPIN14-028 and IDI-2018-000152.

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Author notes

  1. Jorge B. Cannata-Andía and Beatriz Martín-Carro have equal contribution as first authors.

  2. Cristina Alonso-Montes and Natalia Carrillo-López have equal contribution as senior authors.

  3. Jorge B. Cannata-Andía and Natalia Carrillo-López have equal contribution as corresponding authors.

Authors and Affiliations

  1. Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Retic REDinREN-ISCIII, Avda. Roma, sn., 33011, Oviedo, Spain

    Jorge B. Cannata-Andía, Beatriz Martín-Carro, Julia Martín-Vírgala, Javier Rodríguez-Carrio, Cristina Alonso-Montes & Natalia Carrillo-López

  2. Department of Medicine, Universidad de Oviedo, Oviedo, Spain

    Jorge B. Cannata-Andía

  3. Area of Immunology, Department of Functional Biology, University of Oviedo, Oviedo, Spain

    Javier Rodríguez-Carrio

  4. Division of Nephrology, Hospital Universitario Central de Asturias, Retic REDinREN-ISCIII, Oviedo, Spain

    José Joaquín Bande-Fernández

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JCA and NCL had the idea for the article, BMC and JMV performed the literature search and data analysis, NCL, CAM and JCA drafted the article and JCA, JRC, JBF, CAM and NCL critically revised the article.

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Correspondence to Jorge B. Cannata-Andía or Natalia Carrillo-López.

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Cannata-Andía, J.B., Martín-Carro, B., Martín-Vírgala, J. et al. Chronic Kidney Disease—Mineral and Bone Disorders: Pathogenesis and Management. Calcif Tissue Int 108, 410–422 (2021). https://doi.org/10.1007/s00223-020-00777-1

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