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Nephrol Dial Transplant (2004) 19: 534-536
Nephrol Dial Transplant Vol. 19 No. 3 (c) ERA-EDTA 2004; all rights reserved

Editorial Comment

Disturbances of bone and mineral metabolism in chronic kidney disease: an international initiative to improve diagnosis and treatment

Tilman B. Drüeke1 and Sharon M. Moe2

1INSERM Unité 507 and Division of Nephrology, Hôpital Necker, Paris Cedex, France and 2Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA

Correspondence and offprint requests to: Tilman B. Drüeke, MD, Inserm Unité 507, Hôpital Necker, 161 rue de Sèvres, 75743 Paris Cedex 15, France. Email: drueke@necker.fr

Keywords: diagnostic tools; mineral metabolism; renal osteodystrophy; treatment modalities

The first 10% of the full text of this article appears below.



   Introduction
 
Among the numerous complications associated with chronic kidney disease (CKD), disturbances of bone and mineral metabolism have long been recognized. Abnormal plasma calcium and phosphorus concentrations are detected easily by routine biochemistry. Most of the different types of renal osteodystrophy have been reported >50 years ago, others have been described subsequently, and they are all well characterized at present. The problem is that the diagnosis of the precise type of renal osteopathy still requires a bone biopsy, in particular the distinction between low and normal bone turnover. At present, the majority of CKD patients, whether treated by renal replacement therapy or not, refuse to undergo such an invasive diagnostic procedure. The question then arises of how we can do without a bone biopsy, yet provide the patient with a treatment which allows the maintenance or achievement of . . . [Full Text of this Article]



   New diagnostic tools
 


   New treatment options
 


   Recent European algorithms and Australian and American guidelines
 


   NKF conference in Washington, DC
 


   Conclusion and perspectives
 

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