What are the complications of mineral and bone disorder in chronic kidney disease?

Slowed Bone Growth and Deformities

Damaged kidneys must work harder to clear phosphorus from the body. High levels of phosphorus cause lower levels of calcium in the blood, resulting in the following series of events:

• When a person’s blood calcium level becomes too low, the parathyroid glands release parathyroid hormone.
• Parathyroid hormone removes calcium from bones and places it into the blood, raising a person’s blood calcium level at the risk of harming bones.
• A low calcitriol level also leads to an increased level of parathyroid hormone.

If mineral and bone disorder in CKD remains untreated in adults, bones gradually become thin and weak, and a person with the condition may begin to feel bone and joint pain. Mineral and bone disorder in CKD also increases a person’s risk of bone fractures.

Heart and Blood Vessel Problems

In addition to harming bones, mineral and bone disorder in CKD can cause problems in the heart and blood vessels:

• High levels of blood calcium can damage blood vessels and lead to heart problems.
• High phosphorus levels also can cause blood vessels to become like bone, leading to hardening of the arteries.
• High phosphorus levels also cause abnormal hormone regulation, even if the calcium level is acceptable.

Parathyroid hormone and another hormone made in the bones called FGF23 can also affect bone and heart health, leading to the following series of problems:

• When parathyroid hormone or FGF23 levels are high, a person can have heart problems.
• The complex hormone abnormalities that cause bone deformities can also harm a person’s heart and blood vessels.