Disturbances in mineral and bone metabolism are common in patients with chronic kidney disease (CKD), especially those undergoing dialysis. Renal osteodystrophy, which describes an alteration of bone morphology, is an important component of this systemic disorder and may explain the elevated risk of fracture which adversely affects morbidity and mortality. The most common form of renal osteodystrophy is high-turnover bone disease (osteitis fibrosa), which is induced by secondary hyperparathyroidism (SHPT). During the past decade, there has been considerable advances in the management of SHPT, with the introduction of the calcimimetic agents, the optimized use of nutritional and active vitamin D, and the accumulated experience with surgical parathyroidectomy. Studies supported that these advances could translate into improvement of renal bone disease and fracture prevention, as well as decreasing the risk of cardiovascular events and mortality. In this review, we summarize the available clinical evidence on the effect of old and new drugs on bone disorders in patients with CKD.

矿物质和骨代谢紊乱在慢性肾病 (CKD) 患者中很常见，尤其是接受透析的患者。肾性骨营养不良，描述了骨形态的改变，是这种全身性疾病的重要组成部分，可以解释骨折风险升高，这对发病率和死亡率产生不利影响。肾性骨营养不良最常见的形式是高周转率骨病（纤维性骨炎），其由继发性甲状旁腺功能亢进 (SHPT) 诱发。在过去的十年中，随着拟钙剂的引入、营养和活性维生素 D 的优化使用以及手术甲状旁腺切除术的积累，SHPT 的管理取得了长足的进步。研究表明，这些进展可以转化为改善肾骨疾病和预防骨折，以及降低心血管事件和死亡率的风险。在这篇综述中，我们总结了新旧药物对 CKD 患者骨病影响的现有临床证据。