[[GUIDELINES FOR THE PREVENTION, MONITORING AND THERAPY OF CHRONIC KIDNEY DISEASE-METABOLIC BONE DISEASE IN PATIENTS WITH CHRONIC KIDNEY DISEASE].]

Publisher: Zbor Lijecnika Hrvatske Country of Publication: Croatia NLM ID: 0074253 Publication Model: Print Cited Medium: Print ISSN: 0024-3477 (Print) Linking ISSN: 00243477 NLM ISO Abbreviation: Lijec Vjesn Subsets: MEDLINE

Original Publication: Zagreb : Zbor Lijecnika Hrvatske

Bone Diseases, Metabolic*/diagnosis ; Bone Diseases, Metabolic*/etiology ; Bone Diseases, Metabolic*/prevention & control ; Bone Diseases, Metabolic*/therapy ; Patient Care Management*/methods ; Patient Care Management*/organization & administration ; Renal Insufficiency, Chronic*/complications ; Renal Insufficiency, Chronic*/diagnosis ; Renal Insufficiency, Chronic*/therapy; Croatia ; Disease Progression ; Early Diagnosis ; Humans ; Monitoring, Physiologic/methods

Chronic kidney disease (CKD) is a systemic disease with numerous complications associated with increased morbidity and mortality. Chronic kidney disease-metabolic bone disease (CKD-MBD) starts at early stages of CKD with phosphorus accumulation and consequent initiation of numerous events that result with the development of secondary hyperparathyroidism with changes on bones and extraskeletal tissues. The most important and clinically most relevant consequences of CKD-MBD are vascular calcifications which contribute to cardiovascular mortality. Patients with the increased risk for the development of CKD-MBD should be recognized and treated. Prevention is the most important therapeutic option. The first step should be nutritional counseling with vitamin supplementation if necessary and correction of mineral status. Progression of CKD requires more intensive medicamentous treatment with the additional correction of metabolic acidosis and anemia. Renal replacement therapy should be timely initiated, with the adequate dose of dislaysis. Ideally, preemptive renal transplantion should be offered in individuals without contraindication for immunosuppressive therapy.

Date Created: 20171129 Date Completed: 20180208 Latest Revision: 20181202

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