title: Research on kidney and mineral metabolism in Japan: past, present, and future.
abstract: Since the identification of the kidney was the main site for the synthesis of calcitriol (1α, 25-dihydroxycholecalciferol), research on chronic kidney disease (CKD)-associated mineral metabolism disorders and their management has made rapid progress. Various active analogues of calcitriol have clinically become available for treating secondary hyperparathyroidism (SHPT), which is a representative mineral metabolism abnormality in CKD patients. A calcimimetic compound cinacalcet hydrochloride has also been developed for the medical management of SHPT through a different mechanism involving the calcium-sensing receptor. The concept of CKD-mineral and bone disorder (CKD-MBD) was proposed in 2006 to provide a comprehensive understanding of a disorder related to mineral metabolism abnormalities of CKD, based on the fact that these abnormalities are closely associated with cardiovascular disease as well as bone disorders (renal osteodystrophy). There has been a recent surge in the development of phosphate binders for CKD-MBD, focused on an effort to improve mortality. In Japan, high-quality basic and clinical research on CKD-MBD has led to the development of novel therapeutic drugs, such as maxacalcitol, falecalcitriol, and bixalomer. New practice guidelines have been published and are widely adapted in clinical practice.
authors.affiliation: Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Mizobuchi
authors.affiliation: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ogata
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Koiwa
authors.affiliation: Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Kinugasa
authors.affiliation: Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan. akizawa@med.showa-u.ac.jp.|Department of Nephrology, School of Medicine, Showa University School of Medicine, Tokyo, Japan. akizawa@med.showa-u.ac.jp.
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
mesh_terms: D000818:Animals; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy / Q000209:etiology / Q000266:history*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D006962:Hyperparathyroidism, Secondary; D007564:Japan; D007668:Kidney / Q000378:metabolism*; D008903:Minerals / Q000378:metabolism*; D010281:Parathyroid Hormone / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy / Q000266:history*; D012106:Research
chemical_list: D008903:Minerals; D010281:Parathyroid Hormone
keywords: CKD-MBD; Calcimimetics; Parathyroidectomy; Phosphate binder; Vitamin D