A Case Report Of Chronic Kidney Disease-mineral And Bone Disorder And Review Of The Literature

Objective:The aim is to discuss the morbidity,pathogenesis,diagnosis,treatments of the chronic kidney disease-mineral and bone disorder?CKD-MBD?through analyzing and summarizing a typical case of CKD-MBD,which to enhance the understanding,diagnosis and treatments level of CKD-MBD,and command the level of Ca,P,PTH,better,enhance rate of the standard,improve the quality of life of patients,reduce the incidence of cardiovascular events,hospitalization rate because of bone lesion.Method:This report retrospectively analyzed the clinical data of one typical patient with CKD-MBD,integrated with literature at home and abroad and new relevant guide,discuss the morbidity,pathogenesis,diagnosis,treatments of the CKD-MBD.Results:The patient,male,21 year-old,maintenance hemodialysis 6years,PTH goes up more than 4 years?the result of PTH:850-2000 ng/ml at the local hospital?,ache all over 1 year.Clinical diagnosis:1.chronic renal failure Uremic Syndrome CKD-5;maintenance hemodialysis;CKD-MBD.therapeutic process:after commanding the level of P,We give calcitriol?6ug3/w?,after 2 months,the level of PTH has no decline,because of economic reasons,the patient choose PTX+AT.After leaving hospital use calcitriol and calcium carbonate to prevent hypocalcaemia.And adjust the dose drug as the level Ca,P,PTH,now the condition of the patient is steady,and,regular dialysis.Conclusion:CKD-MBD is the common complication of chronic kidney disease,and it has effect the quality of life and prognosis of patients.So CKD-MBD has been the attention of profession,recently.Many studies have verify the abnormal of metabolism of calcium and phosphorus,hoist of Fibroblast growth factor-23,deline of Ca²⁺sensitive receptor of parathyroid cells and klotho,and the condition of effect of Ca,P,PTH,at advanced stage of CKD,promoting the progressof CKD-MBD.Diagnosis of CKD-MBD is based on the level of Ca,P,PTH and imaging diagnosis.Treatments of CKD-MBD is mainly to preventive and cure the disorder of calcium-phosphorus metabolism,cardiovascular calcification,bone lesion,and parathyroidectomy.