Volume 24, Issue 12 (November 2014)

New Developments in CKD-MBD. Development and progression of CKD-MBD in predialysis period ―when and how? Komaba Hirotaka 1 1Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Japan./Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, USA. pp.1771-1778
Published Date 2014/11/28
DOI https://doi.org/10.20837/4201412027
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 Growing interest has been focused on the pathogenesis of chronic kidney disease-mineral and bone disorder(CKD-MBD),which is not restricted to those with end-stage CKD and dialysis patients but also includes those with early-stage CKD. Recent evidence demonstrated that FGF23 levels increase early in CKD to maintain normal phosphate balance, but this results in suppression of renal production of 1,25 dihydroxyvitamin D and thereby triggers the early development of secondary hyperparathyroidism. Thus, it can be interpreted that elevated FGF23 in response to phosphate overload represent the beginning of CKD-MBD. Elevations in FGF23 may also suggest the presence of compensatory response to phosphate retention, underscoring the potential of FGF23 as a new biomarker of phosphate balance. It is hoped that further research in this area will establish the treatment strategy of predialysis CKD-MBD and improves the outcome of CKD patients.


24巻12号 (2014年11月)
電子版ISSN 印刷版ISSN 0917-5857 医薬ジャーナル社