ABSTRACT
Childhood and adolescence are a crucial time for developing a healthy skeletal and vascular system; alterations in bone modeling and remodeling, or vascular biology in youth carry consequences that severely aect quality of life as well as life span. In childhood, chronic kidney disease (CKD) causes disordered regulation of mineral metabolism with subsequent alterations in bone modeling, remodeling, and growth. ese alterations occur early in the course of CKD and, in addition, are associated with the development of cardiovascular calci-cations. Because growth failure and short stature are clinically apparent and concerning to patients, families, and physicians alike, optimization of growth and nal adult height has been a focus of CKD management in children for decades. However, cardiovascular disease is
the leading cause of mortality in both adults and children with kidney disease and abnormal mineral metabolism, bone disease, and its therapies are closely linked to cardiovascular pathologic processes. Together, these alterations are termed CKD mineral and bone disorder (CKD-MBD).1
