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Chronic kidney disease-mineral and bone disorder
Background
Overview
Definition
CKD-MB is a systemic disorder of mineral and bone metabolism due to CKD.
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Pathophysiology
The injured kidney produces circulating signals that directly affect the vasculature, myocardium, and skeleton.
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Epidemiology
Among patients with ESRD undergoing dialysis, the prevalence of CKD-MB is up to 86%.
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Disease course
CKD-MB manifests as abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism; abnormalities in bone turnover, mineralization, volume, growth, or strength; and vascular or other soft-tissue calcification.
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Prognosis and risk of recurrence
Disruptions in bone architecture increase the risk of fracture, while vascular calcification promotes the development of LVH, contributing to the excess cardiovascular risk and excess cardiac mortality seen in patients with CKD.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of chronic kidney disease-mineral and bone disorder are prepared by our editorial team based on guidelines from the Japanese Society of Nephrology (JSN 2019), the Kidney Disease: Improving Global Outcomes Foundation (KDIGO 2017,2009), the Japanese Society of Dialysis Therapy (JSDT 2013), and the United Kingdom Kidney Association (UKKA 2011).
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