engleski

Bone and joint diseases in patients with chronic kidney disease

For more than 50 years, renal osteodystrophy has been known as one of the most common complications of chronic kidney disease. Mineral metabolism disorder develops at the early stages of kidney failure. Hyperphosphataemia, hypocalcaemia and vitamin D deficiency are the most important factors. Mineral metabolism disorder leads not only to the development of bone disease, but also to even more important pathological changes – calcifications of blood vessels. Therefore, renal osteodystrophy is considered a part of the syndrome called chronic kidney disease–mineral bone disorder. In all patients with glomerular filtration rate <60 ml/min, parathyroid hormone, calcium and phosphorus concentrations should be determined and skeletal x-ray and neck ultrasound performed, as indicated. Diet, phosphate binders, vitamin D and its analogues and calcimimetic agents are used in the prevention and treatment of mineral metabolism disorder in these patients. In a smaller number of patients, parathyreoidectomy is required. Prevention and treatment of mineral metabolism disorder in these patients is still a great professional challenge in the area of nephrology.

calcium metabolism disorder; chronic kidney disorder; parathyroid hormone; phosphorus metabolism disorder; renal osteodystrophy; vitamin D

nije evidentirano