CKD mineral and bone disorder
What to measure and how often by CKD stage (KDIGO 2017), reading calcium, phosphate, PTH and ALP together, the high-turnover versus adynamic bone patterns, first-line phosphate and PTH management, tertiary hyperparathyroidism after transplant, and the fracture and denosumab traps.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- CKD mineral and bone disorder (CKD-MBD) is three things together: abnormal calcium, phosphate, PTH, vitamin D and FGF23; bone disease (renal osteodystrophy); and vascular and soft tissue calcification.
- It contributes to fractures, vascular disease and calciphylaxis.
- KDIGO 2017 is still the current guideline in November 2026. KHA-CARI CKD-MBD guidance dates from 2006.
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Sources
- KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl 2017;7:1-59Kidney Disease Improving Global Outcomes, 2017 (still the current version on the KDIGO site, checked November 2026)
- KHA-CARI Guidelines (vitamin D, calcimimetics and phosphate binders; minerals in pre-dialysis patients)AU/NZKidney Health Australia, Caring for Australasians with Renal Impairment, 2006 onwards, online, checked November 2026 (no newer CKD-MBD guideline)
- Chronic Kidney Disease (CKD) Management in Primary Care, 5th editionAU/NZKidney Health Australia, 2024
- EVOLVE Trial Investigators. Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N Engl J Med 2012;367:2482-94New England Journal of Medicine, 2012
- Thadhani R et al. Oral paricalcitol and left ventricular mass in CKD (PRIMO). JAMA 2012;307:674-84JAMA, 2012
- Prolia (denosumab) prescribing information, boxed warning for severe hypocalcaemia in advanced CKDUS Food and Drug Administration (DailyMed), boxed warning January 2024; label checked November 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback