Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease

Nutrients

Vickram Tejwani¹ 

[1] Division of Nephrology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; E-Mail

关键词: calcium homeostasis;    aging;    chronic kidney disease;    mineral and bone disorder;    vascular calcification;    secondary hyperparathyroidism;   

DOI  :  10.3390/nu5061913

来源: mdpi

【 摘 要 】

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.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland.