VIII. How to Manage Serum Phosphate Levels in Predialysis Patients with CKD in the Paradigm of CKD-MBD

Ckd-mineral and Bone Disorders (ckd-mbd)

Serum calcification propensity predicts all-cause mortality in predialysis CKD.

Medial arterial calcification is accelerated in patients with CKD and strongly associated with increased arterial rigidity and cardiovascular mortality. Recently, a novel in vitro blood test that provides an overall measure of calcification propensity by monitoring the maturation time (T50) of calciprotein particles in serum was described. We used this test to measure serum T50 in a prospective...

Alfacalcidol in CKD-MBD - A Fresh Look

Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) is a result of metabolic changes that occur in patients with chronic kidney disease. The consequences are renal osteodystrophy and vascular calcifications, especially seen in the more advanced stages of chronic renal failure. Different treatment regimens including dietary phosphate restriction, oral phosphate binders and active vitamin ...

CKD-MBD KDIGO guidelines: how difficult is reaching the ‘target’?

Patients with chronic kidney disease (CKD) are affected by mineral and bone disorder (MBD), resulting in abnormalities in serum calcium (Ca), phosphorous (P) and parathyroid hormone (PTH). Changes in mineral metabolism have also been associated with higher rates of both all-cause and cardiovascular-related mortality. The majority of haemodialysis patients are also deficient in the endogenous ho...

Prevention and control of phosphate retention/hyperphosphatemia in CKD-MBD: what is normal, when to start, and how to treat?

Phosphate retention and, later, hyperphosphatemia are key contributors to chronic kidney disease (CKD)-mineral and bone disorder (MBD). Phosphate homeostatic mechanisms maintain normal phosphorus levels until late-stage CKD, because of early increases in parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF-23). Increased serum phosphorus, and these other mineral abnormalities, individ...