CKD-MBD in kidney transplant recipients (KTRs) is multifactorial. Although it is characterized by drastic changes in laboratory parameters just after transplantation and uncoupling bone mineral metabolism induced by immunosuppressive drugs and progressive renal dysfunction, its pathophysiology starts before transplantation such that CKD-MBD in dialysis patients arises from predialysis CKD stages. The legacy effect of CKD-MBD gained during dialysis period is rather remarkable, and thus a long-term management of CKD-MBD as a continuum is essential.
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