ROMA (ITALPRESS) – With the arrival of the cold it decreases the time spent outdoors, it reduces exposure to sunlight and increases the sedentaryness: conditions that can favor the falls and aggravate the consequences of bone fragility, especially in the elderly and in patients with kidney damage. To emphasize it is the Italian Society of Nephrology that invites not to underestimate the link between kidney health and bone health. The CKD-MBD (Chronic Kidney Disease-Mineral and Bone Disorder), the mineral and bone disorder associated with Chronic Renal Disease (MRC), in fact affects most neuropathic patients and comes to involve almost total dialysis. A condition that increases the risk of fractures, cardiovascular complications and significantly worsens the quality of life. Feeding, physical activity and regular checks are fundamental to prevent this from happening.
The kidneys play a fundamental role in calcium metabolism, phosphorus and vitamin D. With the progressive reduction of kidney function, this balance can be altered and the CKD-MBD (Chronic Kidney Disease-Mineral and Bone Disorder) can develop, a systemic syndrome characterized by alterations of mineral metabolism and a progressive involvement of bones and cardiovascular apparatus. The abnormalities associated with CKD-MBD may already appear in the early stages of Chronic Renal Disease, to become increasingly frequent with the worsening of kidney function until almost all patients in dialysis.
“When the kidney function decreases, the kidney gradually loses the ability to activate vitamin D and maintain the correct balance between calcium and phosphorus,” explains Filippo Aucella, Elected President of the Italian Society of Nefrology. “This triggers a waterfall of hormonal and metabolic alterations that can compromise the quality of the bones and increase the risk of complications. It is in fact a complex condition that simultaneously affects mineral metabolism, skeleton and cardiovascular system. Increased levels of phosphorus and paratormone (PTH), vitamin D deficiency and bone alterations lead to increased skeletal fragility and increased risk of fractures. In parallel, the same mechanisms promote the appearance of vascular calcifications, associated with increased cardiovascular risk.”.
CKD-MBD is considered one of the main causes of morbidity and mortality in patients with advanced MRC. According to experts, one of the most critical aspects is the lack of patient awareness of the importance of maintaining some fundamental parameters such as phosphorus, calcium and paratormone. The periodic monitoring – every 6 months in the initial stages of disease and every 3 months in dialysis patients – of the mineral and hormonal parameters that represent an essential part of the patient’s taking. SIN specialists recommend: “to maintain, where possible, regular physical activity, avoiding prolonged periods of inactivity; to follow the nutritional indications prescribed by the multidisciplinary team; to carry out periodic controls of calcium, phosphorus, vitamin D and PTH, following the indications of the reference nephrologue”.
“Protecting bones also means protecting the general health of the nephropathic patient,” Aucella concludes. “Premature identification of alterations in mineral and bone metabolism allows you to intervene promptly and reduce the risk of complications that can compromise autonomy and quality of life.”.
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