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Nutrients. 2013 May 29;5(6):1913-36. doi: 10.3390/nu5061913.

Calcium regulation and bone mineral metabolism in elderly patients with chronic kidney disease.

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  • 1Division of Nephrology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. tejwani.vickram@mayo.edu


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.

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