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논문분류	춘계학술대회 초록집
제목	Chronic Kidney Disease-Mineral Bone Disorder in South East Asia: A Narrative Review
저자	Genquen Philip Carado
출판정보	2026; 2026(1):
키워드	Chronic kidney disease–mineral bone disorder, Secondary hyperparathyroidism, Southeast Asia, Health equity, Low- and middle-income countries
초록	Objectives: Chronic kidney disease–mineral bone disorder (CKD-MBD) is a systemic complication of CKD characterized by dysregulated mineral metabolism, abnormal bone turnover, and vascular or soft tissue calcification, collectively increasing fracture risk, impairing functional capacity, and raising cardiovascular mortality. CKD burden in Southeast Asia (SEA) is high and growing, yet CKD-MBD remains under-recognized due to limited access to biochemical testing, imaging, and the heterogeneous socioeconomic conditions across the region. This narrative review synthesizes current evidence on the prevalence, pathophysiology, and management of CKD-MBD, contextualized with SEA data. Methods: A structured literature search of international and regional databases using predefined terms was narratively synthesized. Results: CKD-MBD arises from progressive phosphate retention, reduced calcitriol production, and impaired Klotho expression, driving secondary hyperparathyroidism, high- or low-turnover bone disease, and extra-skeletal calcification. Diagnosis relies on serial serum calcium, phosphate, parathyroid hormone (PTH), and vitamin D measurements, supplemented by bone density imaging and vascular calcification assessment. Access to intact PTH assays, DXA, and advanced imaging remains variable, particularly in low- and lower-middle-income settings. Management centers on maintaining near-normal serum calcium and phosphate through dietary phosphate restriction, phosphate binders, vitamin D sterols and analogues, and parathyroidectomy in refractory cases. Delivery of standard therapy is frequently constrained by inadequate health financing. Prognosis correlates with severity of mineral disturbances; geographic and financial barriers in SEA likely contribute to more pronounced biochemical derangements and higher CKD-MBD–related morbidity. Conclusion: This review highlights critical gaps in early CKD detection, CKD-MBD monitoring, and access to cost-effective therapies. Region-specific implementation of guideline-based care and local economic evaluations are urgently needed. Future research should define CKD-MBD prevalence in SEA, evaluate non-imaging prognostic tools for low-resource settings, and conduct pragmatic trials comparing local interventions against global recommendations.
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