Chronic Kidney Disease-Mineral and Bone Disorder: “Renal Osteodystrophy”
Chronic kidney disease-mineral and bone disorder (CKD-MBD) is the current umbrella term used to describe a group of mineral and bone metabolism disorders secondary to chronic kidney disease (CKD). Bone abnormalities can be observed as early as CKD stage 2 (estimated GFR [eGFR] 60–89 mL/min/1.73 m2). Most patients with CKD stage 5 (eGFR <15 mL/min/1.73 m2) have ominous evidence of bone involvement. Vascular calcifications are the most common form of extraskeletal calcification encountered in this disorder and may develop early. As the GFR decreases, these calcifications become more prevalent, particularly at the coronary arteries. Treatment options range from dietary restrictions to calcium phosphate binders to parathyroidectomy once it has reached advanced stages.