Mineral & Bone Disorder in Chronic Kidney Disease


The kidney is the organ that filters your blood, removes waste products and fluids, and balances the body’s electrolytes (like potassium and sodium). If you have CKD, your kidneys are not properly working. Because of this, you may experience mineral and bone disorder (MBD). MBD is a condition that results when you do not get enough minerals or nutrients needed to build healthy bones

What is mineral & bone disorder in chronic kidney disease (CKD)?

Mineral & Bone Disorder in Chronic Kidney Disease

Mineral and bone disorder (MBD) is a condition that occurs when the body does not provide enough minerals, such as calcium and phosphorous, in the blood.

In CKD, MBD can affect the bones or kidneys.

What are the symptoms of mineral & bone disorders?

The symptoms of mineral and bone disorders can include:

  • Bone pain
  • Bone fractures (broken bones)
  • Weakness, fatigue, or tiredness that does not go away with rest. You may be more tired than usual, even if you get enough sleep. This is especially true if you take dialysis treatment for chronic kidney disease (CKD).
  • Swelling in ankles and legs as well as other parts of the body.

What causes mineral and bone disorders?

Mineral & Bone Disorder in Chronic Kidney Disease

Several factors can contribute to mineral and bone disorders in chronic kidney disease.

  • Low calcium, phosphorus, and potassium levels can cause the body to retain more water, increasing pressure on your bones. This may lead to low bone density or osteoporosis.
  • Your kidneys are responsible for regulating vitamin D levels in your blood. Kidney disease may make it difficult to absorb enough vitamin D from food or sunlight exposure. As a result, you’re at higher risk for developing rickets, osteomalacia (softening of the bones), or osteopenia.
  • High parathyroid hormone levels increase the amount your body removes calcium from its stores within the bones. This process contributes significantly to increased risk for developing osteomalacia or osteoporosis if left untreated over time – especially since people with chronic kidney disease tend not to have enough vitamin D available through diet alone either due to decreased absorption due to slower metabolism rates caused by their condition itself being present so long before symptoms appear.”

How common is mineral and bone disorder?

Mineral and bone disorder is the most common complication of chronic kidney disease (CKD) and affects up to one in four people with CKD. A person with end-stage renal disease (ESRD) has a 60% chance of developing mineral and bone disorders. If left untreated, you may have bones that fracture easily, osteomalacia (softening of bones), osteoporosis (brittle bones), weak muscles, or muscle pain due to a lack of minerals such as magnesium.

Who is more likely to have mineral & bone disorders?

  • People with CKD. Anybody can get a mineral and bone disorder, but those who are most at risk are people with chronic kidney disease (CKD). One study found that about 80 percent of people with CKD developed a mineral and bone disorder during their illness. If you have CKD, you should talk to your doctor about ways to prevent this problem from occurring. They may be able to prescribe medication that helps keep your bones strong while they are being treated for kidney damage.
  • People with type 2 diabetes. Type 2 diabetes is another condition that causes an increased risk of developing a mineral and bone disorder because it prevents the body from properly absorbing the minerals needed for healthy bones.*

What are the complications of mineral & bone disorders?

Mineral & Bone Disorder in Chronic Kidney Disease

  • Bone fractures: When your body doesn’t produce enough calcium, you may be at risk for bone fractures. The most common type of fracture is a stress fracture, which occurs when the bones are weakened from constant pressure. You’re at increased risk for these fractures if you have reduced mobility due to chronic kidney disease or diabetes.
  • Osteoporosis: This condition can cause brittle bones that break easily and put you at greater risk for osteomalacia (softening of the bones). It’s more common in men than women because men have a higher rate of testosterone production, which increases their chances of developing this disorder.
  • Osteomalacia: Osteomalacia can develop if your body is not getting vitamin D from the sun or foods like fatty fish or fortified milk products. Symptoms include muscle spasms and pain in your legs or back caused by softening your bones—this condition can lead to permanent disability if left untreated.


To diagnose mineral and bone disorders, your healthcare professional will ask you to describe your symptoms. They may also order blood tests and imaging studies such as bone scans, X-rays, CT scans, or MRIs.


There are several options for treatment. If a patient is taking medications that can cause an imbalance of minerals, your doctor may switch you to ones that don’t have this effect. Your healthcare provider may also recommend a diet rich in calcium and phosphorus to help prevent or slow down the loss of bone density or mineral imbalance.

What if my kidney disease is advanced?

If you’re on dialysis because only one kidney is working well enough, your doctor might recommend surgery so that the remaining healthy kidney will work better (become an “unassisted” kidney). Surgery could also be considered if both kidneys are not functioning well, but there’s no other medical reason to remove them from your body.

Can I prevent mineral and bone disorders?

  • Calcium
  • Vitamin D
  • Potassium

Clinical Trials for Mineral and Bone Disorder

Clinical trials for chronic kidney disease are a way to test new treatments and procedures before they are widely used. Trials are also important because they help doctors learn more about chronic kidney disease’s causes, symptoms, and long-term effects.

  • What is a clinical trial?

A clinical trial is an experiment that tests a new treatment or procedure. Clinical trials are done in phases: Phase 1 tests the safety of a drug in healthy volunteers; Phase 2 looks at how well the drug works; Phase 3 studies whether a drug is effective against certain diseases or conditions; and Phase 4 examines side effects in large numbers of people who have been taking the medication for some time.

  • Why participate?

Each person involved in a clinical trial has different reasons for participating—some may want to help others with similar problems by contributing data from their own experience. In contrast, others might be paid money or receive other benefits such as free medical care during the study period.* Are there risks? Yes, but we’ll talk about these later on.* What should I do if I get interested in joining one? Talk with your doctor about whether you would qualify for one or more clinical trials related to chronic kidney disease.*


The good news is that you can take steps to lower your risk of developing M&BD. Talk with your doctor about your diet and exercise habits, and ask about the right medications for you. If you have chronic kidney disease, it’s important to work closely with your healthcare team so that they can monitor mineral buildup in your bones, heart, and other organs over time.