Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) is a systemic complication of chronic kidney disease characterized by abnormalities in mineral metabolism, bone structure, and vascular calcification. As kidney function declines, the body’s ability to regulate calcium, phosphorus, vitamin D, and parathyroid hormone becomes impaired, leading to widespread metabolic consequences. CKD-MBD is a major contributor to morbidity in patients with advanced kidney disease in the UAE.

Healthy kidneys maintain mineral balance by excreting excess phosphorus, activating vitamin D, and regulating calcium absorption. In CKD, reduced kidney function leads to phosphate retention and decreased vitamin D activation. These changes stimulate excessive parathyroid hormone release, resulting in secondary hyperparathyroidism. Over time, this hormonal imbalance disrupts bone remodeling and weakens skeletal integrity.

Patients with CKD-MBD may experience bone pain, muscle weakness, fractures, and skeletal deformities. In addition to bone disease, abnormal mineral metabolism promotes vascular and soft tissue calcification, increasing the risk of cardiovascular disease, which is the leading cause of death in CKD patients. These complications may develop silently and progress without obvious symptoms.

Diagnosis involves regular monitoring of serum calcium, phosphorus, parathyroid hormone levels, and vitamin D status, along with assessment of kidney function. Imaging and bone density evaluation may be required in selected cases. Early detection allows timely intervention to reduce complications.

Management focuses on restoring mineral balance and preventing progression of bone and cardiovascular disease. This includes dietary phosphorus control, optimization of calcium and vitamin D levels, and careful hormonal regulation. Treatment is individualized based on CKD stage and laboratory trends. Nephrology supervision is essential to balance therapeutic benefits with potential risks such as vascular calcification.
CKD-MBD is a chronic condition requiring long-term monitoring and multidisciplinary care. Early and consistent management improves bone health, reduces fracture risk, and lowers cardiovascular complications. Patient education and adherence to therapy play a critical role in improving outcomes and quality of life.