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Nutrients 2013, 5(6), 1913-1936; doi:10.3390/nu5061913
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Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease

 and
*
Division of Nephrology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
* Author to whom correspondence should be addressed.
Received: 18 February 2013 / Revised: 25 April 2013 / Accepted: 8 May 2013 / Published: 29 May 2013
(This article belongs to the Special Issue Calcium Needs of Older Adults)
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Abstract

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.
Keywords: calcium homeostasis; aging; chronic kidney disease; mineral and bone disorder; vascular calcification; secondary hyperparathyroidism calcium homeostasis; aging; chronic kidney disease; mineral and bone disorder; vascular calcification; secondary hyperparathyroidism
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
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Tejwani, V.; Qian, Q. Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease. Nutrients 2013, 5, 1913-1936.

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