Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. It often involves diverting blood to a machine to be cleaned. Normally, the kidneys filter the blood, removing harmful waste products and excess fluid and turning these into urine to be passed out of the body. In dialysis patients, the mineral bone axis is deranged. In attempts to optimize this, a number of drugs are usually given, including phosphorus binders, active vitamin D derivatives, and calcium- receptor-sensitizers. Dietary restrictions are often required to limit the amount of phosphorus absorbed. To understand how to manage the mineral bone disorder (MBD) of chronic kidney disease (CKD), a basic understanding of its pathophysiology is helpful.
