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Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease
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; in revised form: 25 April 2013 / Accepted: 8 May 2013 / Published: 29 May 2013
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
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Cite This Article
MDPI and ACS Style
Tejwani, V.; Qian, Q. Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease. Nutrients 2013, 5, 1913-1936.
Tejwani V, Qian Q. Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease. Nutrients. 2013; 5(6):1913-1936.
Tejwani, Vickram; Qian, Qi. 2013. "Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease." Nutrients 5, no. 6: 1913-1936.