Mineral Bone Disorder in Hemodialysis Patients

Abstract

Introduction: Chronic kidney disease-mineral bone disorder (CKD-MBD) contributes to fracture, cardiovascular disease, and mortality. Methods: Literature review of 45 studies on phosphate binders, vitamin D analogs, and calcimimetics in hemodialysis patients. Results: Non-calcium-based phosphate binders (sevelamer, lanthanum) reduced coronary calcification progression by 30% compared to calcium-based binders. Cinacalcet lowered parathyroid hormone by 50–70% but did not improve mortality in meta-analyses. Discussion: Individualized PTH, calcium, and phosphate targets are essential. Over-suppression of PTH increases adynamic bone disease risk. Conclusion: Multimodal therapy targeting specific biochemical parameters improves outcomes.