title: Pathophysiology of chronic kidney disease-mineral and bone disorder.
abstract: Chronic kidney disease (CKD) alters the metabolism of several minerals, thereby inducing bone lesions and vessel-wall calcifications that can cause functional impairments and excess mortality. The histological bone abnormalities seen in CKD, known as renal osteodystrophy, consist of alterations in the bone turnover rate, which may be increased (osteitis fibrosa [OF]) or severely decreased (adynamic bone disease [AD]); abnormal mineralization (osteomalacia [OM]), and bone loss. Secondary hyperparathyroidism is related to early phosphate accumulation (responsible for FGF23 overproduction by bone tissue), decreased calcitriol production by the kidneys, and hypocalcemia. Secondary hyperparathyroidism is associated with OF. Other factors that affect bone include acidosis, chronic inflammation, nutritional deficiencies, and iatrogenic complications.
authors.affiliation: INSERM U1059, université de Lyon, Saint-Étienne cedex 2, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Mac Way
authors.forename: Myriam
authors.initials: M
authors.lastname: Lessard
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Lafage-Proust
mesh_terms: D015519:Bone Density / Q000502:physiology*; D001847:Bone Diseases / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology*; D002118:Calcium / Q000378:metabolism; D015897:Comorbidity; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism; D006801:Humans; D010281:Parathyroid Hormone / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology*; D014807:Vitamin D / Q000378:metabolism
chemical_list: C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002118:Calcium