Definition
The skeletal manifestation of chronic kidney disease-mineral and bone disorder.
Pathophysiology
- Impaired phosphate excretion
- Reduced vitamin D activation
- Hypocalcaemia
- Secondary hyperparathyroidism
- Disturbed bone turnover and mineralisation
Clinical features
- Bone pain
- Fracture risk
- Deformity in severe or longstanding disease
- Extraskeletal calcification may occur as part of CKD-MBD
Management
- Control phosphate
- Active vitamin D therapy where appropriate
- Manage secondary hyperparathyroidism
- Orthopaedic management of fractures and deformity as needed
Diagram
