Chronic kidney disease mineral and bone disorder A guide for general practice

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