Chronic kidney disease mineral and bone disorder: A guide for general practice
Krita Sridharan
Abstract
BACKGROUND: Chronic kidney disease mineral and bone disorder (CKD-MBD) is an important cause of morbidity, cardiovascular risk and mortality among patients with chronic kidney disease (CKD). The condition begins to manifest in stage 3a CKD. General practitioners play a crucial part in screening, monitoring and early management of this important problem, which is primarily managed in the community. OBJECTIVE: The aim of this article is to summarise the key evidence-based principles of the pathogenesis, assessment and management of CKD-MBD. DISCUSSION: CKD-MBD includes a spectrum of disease involving biochemical changes, bone abnormalities and vascular and soft tissue calcification. Management is centred on monitoring and controlling biochemical parameters with a variety of strategies to improve bone health and cardiovascular risk. The range of evidence-based treatment options is reviewed in this article.