title: Calcium regulation and bone mineral metabolism in elderly patients with chronic kidney disease.
abstract: The elderly chronic kidney disease (CKD) population is growing. Both aging and CKD can disrupt calcium (Ca2+) homeostasis and cause alterations of multiple Ca2+-regulatory mechanisms, including parathyroid hormone, vitamin D, fibroblast growth factor-23/Klotho, calcium-sensing receptor and Ca2+-phosphate product. These alterations can be deleterious to bone mineral metabolism and soft tissue health, leading to metabolic bone disease and vascular calcification and aging, termed CKD-mineral and bone disorder (MBD). CKD-MBD is associated with morbid clinical outcomes, including fracture, cardiovascular events and all-cause mortality. In this paper, we comprehensively review Ca2+ regulation and bone mineral metabolism, with a special emphasis on elderly CKD patients. We also present the current treatment-guidelines and management options for CKD-MBD.
authors.affiliation: Division of Nephrology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. tejwani.vickram@mayo.edu
authors.forename: Vickram
authors.initials: V
authors.lastname: Tejwani
authors.forename: Qi
authors.initials: Q
authors.lastname: Qian
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000818:Animals; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D002118:Calcium / Q000378:metabolism*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood / Q000172:deficiency; D005966:Glucuronidase / Q000097:blood / Q000172:deficiency; D017408:Guidelines as Topic; D006706:Homeostasis; D006801:Humans; D000090265:Klotho Proteins; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D044169:Receptors, Calcium-Sensing / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D014807:Vitamin D / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D044169:Receptors, Calcium-Sensing; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D005966:Glucuronidase; D000090265:Klotho Proteins; D002118:Calcium