Chronic Kidney Disease-Mineral Bone Disorders (CKD-MBD)

CKD-MBD is defined by the Kidney disease: Improving Global Outcomes (KDIGO) as a systemic disorder of mineral bone metabolism due to chronic kidney disease manifested by either one or a combination of the following:

  1. Abnormalities of calcium, phosphorus, PTH and Vitamin D metabolism.
  2. Abnormalities in bone turnover, mineralization, volume, linear growth or strength.
  3. Vascular or other soft tissue calcification. 

Disorders of mineral and bone metabolism are common among patients with CKD, with average prevalence between 35-65%.

CKD-MBD is associated with increased cardiovascular risk, fracture risk, reduced quality of life and increased mortality.

Management is complicated and involves screening of biomarkers, diet control and treatment of various underlying illnesses. 

Role of Calcimimetics.

Calcimimetic agents are used in the management of primary, secondary and tertiary hyperparathyroidism. In secondary hyperparathyroidism,calcimimetics can be used alone or in combination with calcitriol.Calcimimetics are positive modulators of the calcium-sensing receptor( CaSR) found in the parathyroid glands. They increase the sensitivity of the CaSR to ionized calcium, lowering the calcium set point and resulting in reduction of PTH secretion from the parathyroid gland.


CIPHROCET( Cinacalcet) , from Sisi is available as 30 mg tablets administered orally daily.