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Current concepts and management strategies in chronic kidney disease-mineral and bone disorder.
South Med J. 2012 Sep; 105(9):479-85.SM

Abstract

The term renal osteodystrophy describes the pathological changes in bone structure in chronic kidney disease (CKD); however, this term fails to describe adequately the adverse changes in mineral and hormonal metabolism in CKD that have grave consequences for patient survival. CKD-mineral and bone disorder (CKD-MBD) is a broader, newly defined term that should be used instead of renal osteodystrophy to define the mineral, bone, hormonal, and calcific cardiovascular abnormalities that are seen in CKD. The new paradigm in the management of renal bone disease is to "think beyond the bones" and strive to improve cardiovascular outcomes and survival. This means treating other aspects of the disease process that go beyond merely controlling parathyroid hormone levels. Primary physicians need to take a proactive approach to the management of CKD-MBD because the disorder begins early in the course of CKD, well before a patient is referred to a nephrologist. This review outlines the evidence behind the understanding of CKD-MBD, its implications for overall mortality, and the latest recommendations for management of CKD-MBD in patients with predialysis CKD.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine, Drexel University College of Medicine and Hahnemann University Hospital, Philadelphia, PA 19102, USA. veeraish.chauhan@drexelmed.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22948328

Citation

Chauhan, Veeraish, et al. "Current Concepts and Management Strategies in Chronic Kidney Disease-mineral and Bone Disorder." Southern Medical Journal, vol. 105, no. 9, 2012, pp. 479-85.
Chauhan V, Kelepouris E, Chauhan N, et al. Current concepts and management strategies in chronic kidney disease-mineral and bone disorder. South Med J. 2012;105(9):479-85.
Chauhan, V., Kelepouris, E., Chauhan, N., & Vaid, M. (2012). Current concepts and management strategies in chronic kidney disease-mineral and bone disorder. Southern Medical Journal, 105(9), 479-85. https://doi.org/10.1097/SMJ.0b013e318261f7fe
Chauhan V, et al. Current Concepts and Management Strategies in Chronic Kidney Disease-mineral and Bone Disorder. South Med J. 2012;105(9):479-85. PubMed PMID: 22948328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current concepts and management strategies in chronic kidney disease-mineral and bone disorder. AU - Chauhan,Veeraish, AU - Kelepouris,Ellie, AU - Chauhan,Nishtha, AU - Vaid,Megha, PY - 2012/9/6/entrez PY - 2012/9/6/pubmed PY - 2012/11/9/medline SP - 479 EP - 85 JF - Southern medical journal JO - South Med J VL - 105 IS - 9 N2 - The term renal osteodystrophy describes the pathological changes in bone structure in chronic kidney disease (CKD); however, this term fails to describe adequately the adverse changes in mineral and hormonal metabolism in CKD that have grave consequences for patient survival. CKD-mineral and bone disorder (CKD-MBD) is a broader, newly defined term that should be used instead of renal osteodystrophy to define the mineral, bone, hormonal, and calcific cardiovascular abnormalities that are seen in CKD. The new paradigm in the management of renal bone disease is to "think beyond the bones" and strive to improve cardiovascular outcomes and survival. This means treating other aspects of the disease process that go beyond merely controlling parathyroid hormone levels. Primary physicians need to take a proactive approach to the management of CKD-MBD because the disorder begins early in the course of CKD, well before a patient is referred to a nephrologist. This review outlines the evidence behind the understanding of CKD-MBD, its implications for overall mortality, and the latest recommendations for management of CKD-MBD in patients with predialysis CKD. SN - 1541-8243 UR - https://www.unboundmedicine.com/medline/citation/22948328/Current_concepts_and_management_strategies_in_chronic_kidney_disease_mineral_and_bone_disorder_ L2 - http://dx.doi.org/10.1097/SMJ.0b013e318261f7fe DB - PRIME DP - Unbound Medicine ER -