Mineral and Bone Disorder in Chronic Kidney Disease O-H.pdf

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1. Mineral and Bone Disorder in
Chronic Kidney Disease
Osama Hroub
Supervised by Dr Ma’moun Qawasmeh

2. Contents
✓Definitions
✓Hormones and Minerals Important for Bone Health
✓Pathophysiology
✓renal osteodystrophy
✓Symptoms and Complications
✓Diagnostics
✓Treatment

3. Definitions
➢CKD-MBD occurs when kidneys damaged by CKD cannot
effectively filter blood and regulate hormones. As a result, hormone
levels and mineral levels (such as calcium and phosphorus) become
imbalanced, leading to damage.
➢The bone disease component of mineral and bone disorder is called
renalosteodystrophy.

4. Hormones and Minerals Important for Bone Health
❖Healthy bones continuously rebuild, and hormones and minerals play
crucial roles in maintaining bone strength.
❖Key factors include:
a)Calcium and phosphorus: Essential for bone growth and rebuilding.
b)Parathyroid hormone (PTH): Regulates calcium and phosphorus
levels.
c)Calcitriol: An active form of vitamin D that helps bones utilize
calcium.
d)Fibroblast growth factor 23 (FGF23): Involved in mineral balance.

9. Pathophysiology

11. Renal osteodystrophy
Types:
▪Osteitis fibrosa cystica: Excess PTH causes bone resorption.
▪Osteomalacia: Reduced calcitriol leads to inadequate mineralization.
▪Adynamic bone disease: Suppressed bone turnover due to low PTH.

12. Symptoms and Complications
•Musculoskeletal
•Fractures
•Bone and periarticularpain
•Muscular weakness andpain

13. Diagnostics

14. Treatment
The goal is to normalize phosphate, calcium, and PTH levels.
•Treatment of hyperphosphatemia
•Treatment of hyperparathyroidism, e.g.:
•Calcimimetics (e.g., cinacalcet)
•Parathyroidectomy