MINERAL AND BONE DISORDER IN CHRONIC KIDNEY DISEASE
Mineral and bone disorder in chronic kidney disease (CKD) is a disorder that can affect the bones, heart, and blood vessels of a person with CKD. Mineral and bone disease occurs when kidneys damaged by CKD can’t filter blood NIH external link and regulate hormones the way they should. The hormone levels and levels of minerals, such as calcium and phosphorus, then become imbalanced, leading to damage.
Kidney damage from CKD causes mineral and bone disorder because the damaged kidneys do not properly balance the mineral and hormone levels in the body. Damaged kidneys stop
- turning vitamin D into calcitriol, creating an imbalance of calcium in your blood
- removing excess phosphorus from your blood, triggering your blood to pull calcium out of your bones and causing them to weaken
Also, when your kidneys are damaged, your parathyroid glands, which are located in your neck but are not related to your thyroid function, release extra PTH into your blood to move calcium from your bones to restore your blood calcium levels; but this response also starves your bones of much-needed calcium.
Mineral and bone disorder is more common in people with CKD who have kidney failure and are on dialysis.
People who have kidney failure—and whose mineral and bone disorder is more evident—are more likely to be1
- age 65 or older
- non-Hispanic Black
People who do not follow the kidney diet, do not take their phosphate binder medications, or do not stay on dialysis for the full prescribed time will have more severe CKD-MBD.
The complications of mineral and bone disorder include
- slowed bone growth and bone deformities
- bone fractures
- heart and blood vessel problems
People who experience these complications may have a poorer quality of life, may spend more time in the hospital, and have a higher risk of fractures or death.3
Slowed bone growth and bone deformities
Damaged kidneys must work harder to remove phosphorus from your body. Buildup of phosphorus is associated with less calcium in your blood and with the release of PTH by your parathyroid glands. PTH moves calcium out of your bones and into your blood. The loss of calcium can harm your bones.
Complications could include
- slowed bone growth, leading to short stature that may remain into adulthood
- a deformity sometimes called “renal ricketsNIH external link”, in which the legs bend inward or outward
- increased likelihood of bone fractures
If you’re an adult with mineral and bone disorder, and the condition remains untreated, your
- bones gradually become thin and weak.
- bones and joints may begin to feel painful.
- risk of developing low bone mineral content, called weak bones related with CKDNIH external link, increases. If severe, weak bones related with CKD may increase your likelihood of fractures or broken bones.
HEART AND BLOOD VESSEL PROBLEMS
Mineral and bone disorder can not only harm your bones. It can also increase your risk of heart attacks, strokes, and death.
- High levels of blood calcium can damage your blood vessels and lead to heart problems.
- High levels of phosphorus can
- cause your blood vessels to harden—a process known as calcification.
- cause abnormal hormone regulation, even if your calcium level is acceptable.
- High levels of PTH and another hormone made in the bones, called FGF23, can also harm both your bones and your heart and blood vessels.
Adults with mineral and bone disorder may feel bone and joint pain. However, these symptoms may not appear until a person has had the disorder for many years.
In children, mineral and bone disorder is particularly serious because their bones are still developing and growing. Unlike adults, children can show visible bone changes from mineral and bone disorder in the early stages of CKD. For example, they may not grow as expected—a condition known as growth failure—or their bones may become weak from lack of calcium.
Eating, diet, and nutrition
Changing what you eat and drink can help treat mineral and bone disorder. Eating fewer foods that contain phosphorus is one of the most important steps to help you prevent bone disease and blood vessel calcification.
Most foods contain some phosphorus. However, most processed and packaged foods, such as lunch meats and canned or boxed foods, contain high levels. Food producers use phosphorus as a food preservative. If you have CKD or are on dialysis, avoid packaged foods containing ingredients that include the letters “PHOS.”
CALCAREA PHOS 30- Calcarea phos is one of the top homoeopathic medicines in weak bones related with CKD. Here the bones are delicate and easily breakable.The bones of the head are deficient in quality and quantity. This will promote the absorption of calcium from the food that the patient takes. The bones of the neck are too small and weak to support the head which is normally large. The bones of the extremities are also weak and fragile.
Calcarea phosphorica is an excellent medicine for treating curvature of spine in weak bones related with CKD patients. It is mainly given to those patients of weak bones related with CKD who have weak spine and soft bones which lead to curvature of spine .Such patients are unable to support their body. This homeopathic medicine is also used if anaemia is present along with curvature of spine in weak bones related with CKD patients. Calcarea phosphorica is also prescribed in curvature of spine when associated backache which is worse in cold weather and from exertion . Stools green, undigested and offensive. No appetite, it is a bone builder and creates new blood cells. It gives general tone to the entire organism.
CALCAREA CARB.-Calcarea carb. is often helpful to individuals who are easily tired by exertion and tend to feel anxious and overwhelmed from work or stress. The person may be chilly, flabby or overweight, and feel worse from cold and dampness. Back pain, swollen joints, and a sweaty head at night are often seen. People who need this remedy often have strong cravings for both eggs and sweets.
CACAREA FLOUR. —Calcarea flour. Is prescribed when cracking in the joints is present. Easy joint dislocation . Swelling and indurated enlargements haing their seat in the tissue and ligaments, tendons of joints. Chronic lumbago. Lumbago worse on beginning to move and ameliorated on continued motion.Better from rubbing, warm application
SYMPHYTUM OFFICINALE —Symphytum officinale is the top remedy for treating fractures in weak bones related with CKD. Symphytum officinale is commonly known as ‘knit bone’ and as the name represents it helps in knitting/uniting the fractured bone by increasing the callous production. This remedy helps in union of fractured bone very efficiently. Fractures where patients complain of pricking type of pain at fractured site can be greatly relieved by this medicine. Symphytum can also help in reducing the irritability at the site of fracture .
RUTA GRAVEOLENS 30- Ruta Graveolens is another effective remedy employed in the treatment of fractures in weak bones related with CKD.Whenever a bone gets fractured the surrounding tendons and ligaments of bones also get damaged. This medicine helps in healing torn tendons and ligaments. It also helps in repairing the damaged bone. This homeopathic remedy helps in decreasing the pain, soreness and stiffness around fractured area mainly wrist fracture
HYPERICUM PERFORATUM 30--Hypericum perforatum is the another useful Homeopathic medicine that can be used with confidence for the excessive pain in back due to crushing of nerves in between damaged vertebral bones. The excessive pains and sensitiveness in back after fracture of vertebral bones that are worse by slight motion of neck or arms ,can be efficiently controlled by Hypericum .
SILICEA 200-Silicea is another excellent that can cure of fracture in weak bones related with CKD patients. Silicea is usually prescribed in those patients of weak bones related with CKD in which the disease is due to defective assimilation of calcium . In such cases Silicea is of considerable use and it helps by enhancing the assimilation power of digestive system. Silicea is also very helpful where pus or fistula formation has occurred at the site of fracture. Silicea helps in efficient union of broken bone and it also held in removing bone splinters