Management of renal bone disease

Renal bone disease occurs in patients with chronic kidney disease. There are changes in the concentrations of calcium, phosphate, vitamin D and parathyroid hormone. Systemic complications include renal osteodystrophy and soft tissue calcification, which contribute to morbidity and mortality. As the changes of renal bone disease are potentially modifiable, early referral to a nephrologist for monitoring and treatment is recommended. Early advice about diet and regular monitoring of calcium, phosphate and parathyroid hormone are necessary. Careful prescribing of drugs and dialysis to achieve specific biochemical targets can minimise the complications. Phosphate binders and vitamin D analogues are required by most patients with advanced renal failure.