Disease of the MonthMetabolic Bone Disease in Chronic Kidney DiseaseMartin, Kevin J.; Gonza[Combining Acute Accent]lez, Esther A. Author Information Division of Nephrology, Saint Louis University, St. Louis, MO Address correspondence to: Dr. Kevin J. Martin, Division of Nephrology, Saint Louis University Medical Center, Division of Nephrology (9-FDT), 3635 Vista Avenue, St. Louis, MO 63110l. Phone: 314-577-8765; Fax: 314-771-0784; [email protected] Journal of the American Society of Nephrology 18(3):p 875-885, March 2007. | DOI: 10.1681/ASN.2006070771 Buy Metrics Abstract Metabolic bone disease is a common complication of chronic kidney disease (CKD) and is part of a broad spectrum of disorders of mineral metabolism that occur in this clinical setting and result in both skeletal and extraskeletal consequences. Detailed research in that past 4 decades has uncovered many of the mechanisms that are involved in the initiation and maintenance of the disturbances of bone and mineral metabolism and has been translated successfully from “bench to bedside” so that efficient therapeutic strategies now are available to control the complications of disturbed mineral metabolism. Recent emphasis is on the need to begin therapy early in the course of CKD. Central to the assessment of disturbances in bone and mineral metabolism is the ability to make an accurate assessment of the bone disease by noninvasive means. This remains somewhat problematic, and although measurements of parathyroid hormone are essential, recently recognized difficulties with these assays make it difficult to provide precise clinical practice guidelines for the various stages of CKD at the present time. Further research and progress in this area continue to evaluate the appropriate interventions to integrate therapies for both the skeletal and extraskeletal consequences with a view toward improving patient outcomes. Copyright © 2007 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.