Introduction: expanding concepts of chronic kidney disease-mineral and bone disorder (CKD-MBD)

Abstract

Ever since the paradigm shift from ‘renal osteodystrophy' to ‘chronic kidney disease-mineral and bone disorder' (CKD-MBD),1 drastic changes of research interests have been taking place. As a systemic disorder, hard outcomes of CKD-MBD not only include bone fractures, but also cardiovascular events and survival. The problem is, however, that even recent clinical guidelines had still to be based mainly on results of observational studies because of insufficient hard outcome data in response to various treatment modalities.2, 3 Both in basic and clinical research devoted to CKD, cardiovascular complications including vascular calcification have become the main targets although a causal link between CKD-MBD and cardiovascular events has not yet been firmly established. Only the definitive confirmation of such a link will allow consolidation of the concept, in the next decade, that CKD-MBD has a major role in the high incidence of cardiovascular disease in patients with CKD. This issue of Kidney International Supplements is based on symposia at the 58th Annual Congress of the Japanese Society for Dialysis Therapy, held in Fukuoka, Japan in June 2013. At the symposia, experts from several countries discussed various key issues in this field, including new pathophysiological models, disease markers, and pharmacological interventions. We hope that this supplement will inspire young researchers to identify new targets and develop novel treatment modalities in the field of CKD-MBD in the near future.