Interní Med. 2010; 12(2): 67-71

Advances in the diagnosis and treatment of renal bone disease

MUDr.Mgr.Jitka Štěpánková¹, prof.MUDr.Sylvie Dusilová-Sulková, DrSc.^1,2

¹ Klinika nefrologie, Transplantační centrum IKEM, Praha

² Klinika gerontologická a metabolická LF UK a FN Hradec Králové

The reduction of renal function leads to disturbed calcium, phosphorus metabolism, impaired action of calcitriol, increased parathyroid

hormone, FGF 23. Unless appropriate treatment these abnormalities in mineral metabolism and endocrine regulation can cause changes

in bone structure (renal bone disease) and development of extraosseous calcifications. This systemic disorder is defined as Chronic Kidney

Disease – Mineral and Bone Disorder (CKD-MBD) and it is associated with increased morbidity and mortality of CKD patients.

The type of renal bone disease can be exactly diagnosed only by a bone biopsy providing measurement of bone turnover, mineralization

and volume (TMV). However, this examination is performed for its invasive nature rarely. Hence, biochemical markers, clinical and X-ray

investigation are used in evaluation of renal osteodystrophy instead of bone biopsy in most patients.

The aim of renal bone disease treatment is to control phosphatemia, calcemia and to influence secondary hyperparathyreoidism either

conservative (phosphate binders, calcitriol or vitamin D analogs, calcimimetics) or invasive (parathyreoidectomy).

Keywords: renal bone disease, secondary hyperparathyreoidism, vascular calcifications, chronic kidney disease

Published: May 1, 2010  Show citation