Journal of Nephrology

, Volume 32, Issue 5, pp 709–717 | Cite as

The role of uric acid in mineral bone disorders in chronic kidney disease

  • Baris Afsar
  • Alan A. Sag
  • Cinar Oztosun
  • Masanari Kuwabara
  • Mario Cozzolino
  • Adrian Covic
  • Mehmet KanbayEmail author


Increasing survival in the chronic kidney disease (CKD) population exposes the bone to the cumulative detrimental sequelae of CKD, now defined physiologically and histopathologically as chronic kidney disease mineral bone disorder (CKD-BMD). This disorder is increasingly recognized as a “nontraditional” driver of morbidity and mortality and presents an opportunity to improve CKD outcomes via research. However, recent advances in the literature on this topic have not yet been collected into a single review. Therefore, this report aims to discuss the disordered renal-bone axis in CKD-BMD, molecular and hormonal drivers, novel treatment strategies, and forthcoming research in a clinician-directed format. A key novel topic will be the unique impact of uric acid on CKD-BMD, which is poised to apply extensive existing research in the uric acid domain to benefit the CKD-BMD population.


Uric acid Mineral bone disorder FGF-23 Vitamin D Parathyroid hormone 



MK The authors gratefully acknowledge use of the services and facilities of the Koç University Research Center for Translational Medicine (KUTTAM), funded by the Presidency of Turkey, Presidency of Strategy and Budget. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Presidency of Strategy and Budget.


This study was not funded by any grant.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

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


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© Italian Society of Nephrology 2019

Authors and Affiliations

  1. 1.Division of Nephrology, Department of MedicineSuleyman Demirel University School of MedicineIspartaTurkey
  2. 2.Division of Vascular and Interventional Radiology, Department of RadiologyDuke University Medical CenterDurhamUSA
  3. 3.Department of Medicine, School of MedicineKoç UniversityIstanbulTurkey
  4. 4.Department of CardiologyToranomon HospitalTokyoJapan
  5. 5.Renal Division, Department of Health SciencesUniversity of MilanMilanItaly
  6. 6.Nephrology Clinic, Dialysis and Renal Transplant Center‘C.I. PARHON’ University Hospital, and ‘Grigore T. Popa’ University of MedicineIasiRomania
  7. 7.Division of Nephrology, Department of MedicineKoc University School of MedicineIstanbulTurkey

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