CKD-MBD: from the Pathogenesis to the Identification and Development of Potential Novel Therapeutic Targets

• Main Author: Elias, Rosilene Motta
• Publication Date: 2018
• Other Authors: Dalboni, Maria Aparecida, Coelho, Ana Carolina E. [UNESP], Moysés, Rosa M. A.
• Format: Other
• Language: eng
• Source: Repositório Institucional da UNESP
• Download full: http://dx.doi.org/10.1007/s11914-018-0486-0; http://hdl.handle.net/11449/186939
• topic: CKD-MBD; FGF-23; Osteocyte; Sclerostin; Secondary hyperparathyroidism

Purpose of Review: Although we have seen tremendous advances in the comprehension of CKD-MBD pathophysiology during the last few years, this was not accompanied by a significant change in mortality rate and quality of life. This review will address the traditional and updated pathophysiology of CKD-MBD along with the therapeutic limitations that affect CKD-MBD and proposed alternative treatment targets. Recent Findings: An innovative concept brings the osteocyte to the center of CKD-MBD pathophysiology, in contrast to the traditional view of the skeleton as a target organ for disturbances in calcium, phosphate, parathyroid hormone, and vitamin D. Osteocytes, through the synthesis of FGF-23, sclerostin, among others, are able to interact with other organs, making bone an endocrine organ. Thus, osteocyte dysregulation might be an early event during the course of CKD. Summary: This review will revisit general concepts on the pathophysiology of CKD-MBD and discuss new perspectives for its treatment.