Major recent changes in the definition, diagnosis and treatment of mineral and bone disease require the update of prior recommendations for clinical practice guidelines. Today, the term renal osteodystrophy has been replaced by (CKD-MBD-chronic kidney disease-mineral bone disease). To reflect the multiple abnormalities in bone and mineral metabolism associated with chronic kidney disease. These alterations play a key role in the pathogenesis of extraskeletal calcifications, both vascular and soft tissue. Their appareance is directly related to cardiovascular complications and the high mortality of renal patients.