CKD-MBD: from the Pathogenesis to the Identification and Development of Potential Novel Therapeutic Targets

  • Rosilene Motta Elias
  • Maria Aparecida Dalboni
  • Ana Carolina E. Coelho
  • Rosa M. A. Moysés
Kidney and Bone (I Salusky and T Nickolas, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Kidney and Bone


Purpose of Review

Although we have seen tremendous advances in the comprehension of CKD-MBD pathophysiology during the last few years, this was not accompanied by a significant change in mortality rate and quality of life. This review will address the traditional and updated pathophysiology of CKD-MBD along with the therapeutic limitations that affect CKD-MBD and proposed alternative treatment targets.

Recent Findings

An innovative concept brings the osteocyte to the center of CKD-MBD pathophysiology, in contrast to the traditional view of the skeleton as a target organ for disturbances in calcium, phosphate, parathyroid hormone, and vitamin D. Osteocytes, through the synthesis of FGF-23, sclerostin, among others, are able to interact with other organs, making bone an endocrine organ. Thus, osteocyte dysregulation might be an early event during the course of CKD.


This review will revisit general concepts on the pathophysiology of CKD-MBD and discuss new perspectives for its treatment.


CKD-MBD Osteocyte Secondary hyperparathyroidism FGF-23 Sclerostin 


Compliance with Ethical Standards

Conflict of Interest

Rosilene Motta Elias, Maria Aparecida Dalboni, Ana Carolina Coelho, and Rosa MA Moysés declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rosilene Motta Elias
    • 1
    • 2
  • Maria Aparecida Dalboni
    • 1
  • Ana Carolina E. Coelho
    • 3
  • Rosa M. A. Moysés
    • 1
    • 2
  1. 1.Universidade Nove de Julho, UNINOVESão PauloBrazil
  2. 2.Nephrology Division, HCFCMUSPUniversidade de São PauloSão PauloBrazil
  3. 3.Nephrology DivisionUniversidade Estadual Paulista, UNESPSão PauloBrazil

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