Ilkun O, Jazayeri F, Kazory A. Emerging treatments and current strategies for mineral, vascular, and bone disorders in chronic kidney disease. World J Nephrol 2026; 15(1): 114146 [DOI: 10.5527/wjn.v15.i1.114146]
Corresponding Author of This Article
Olesya Ilkun, MD, PhD, Assistant Professor, FASN, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610-0224, United States. olesya.ilkun@medicine.ufl.edu
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Urology & Nephrology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 25, 2026 (publication date) through Mar 14, 2026
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Publication Name
World Journal of Nephrology
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2220-6124
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Ilkun O, Jazayeri F, Kazory A. Emerging treatments and current strategies for mineral, vascular, and bone disorders in chronic kidney disease. World J Nephrol 2026; 15(1): 114146 [DOI: 10.5527/wjn.v15.i1.114146]
World J Nephrol. Mar 25, 2026; 15(1): 114146 Published online Mar 25, 2026. doi: 10.5527/wjn.v15.i1.114146
Emerging treatments and current strategies for mineral, vascular, and bone disorders in chronic kidney disease
Olesya Ilkun, Firouzeh Jazayeri, Amir Kazory
Olesya Ilkun, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, Gainesville, FL 32610-0224, United States
Firouzeh Jazayeri, UF Health Outpatient Dialysis Unit, UF Health, Gainesville, FL 32610, United States
Amir Kazory, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, Gainesville, FL 32610, United States
Author contributions: Kazory A submitted the manuscript; Ilkun O, Jazayeri F, and Kazory A searched the literature, designed, wrote, edited, and revised the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Olesya Ilkun, MD, PhD, Assistant Professor, FASN, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610-0224, United States. olesya.ilkun@medicine.ufl.edu
Received: September 15, 2025 Revised: October 7, 2025 Accepted: December 17, 2025 Published online: March 25, 2026 Processing time: 183 Days and 4.1 Hours
Abstract
Progressive loss of kidney function in chronic kidney disease and end-stage kidney disease leads to distinct pathological changes in mineral and bone metabolism. Historically, the management of these patients focused on lowering their serum phosphate, parathyroid hormone, and normalizing serum calcium. However, persistently high morbidity and mortality of these patients from cardiovascular diseases and after bone fractures call for more specific therapies. Here, we summarize established and emerging therapies for managing the three main domains of mineral bone disorder in patients with advanced chronic kidney disease and end-stage kidney disease: Control of mineral imbalance, management of vascular disease or other soft tissue calcifications, and management of bone disorders.
Core Tip: Patients with advanced chronic kidney disease and end-stage kidney disease experience disproportionally high morbidity and mortality compared to the general population, particularly from cardiovascular disease and following bone fractures. Recent data indicate that this phenomenon is due to kidney disease-induced alterations in the fundamental biological pathways. Herein, we review established and emerging therapies for the management of mineral bone disorder, vascular and tissue calcifications, and bone pathology.
