KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)

Tamara Isakova*, Thomas L. Nickolas, Michelle Denburg, Sri Yarlagadda, Daniel E. Weiner, Orlando M. Gutiérrez, Vinod Bansal, Sylvia E. Rosas, Sagar Nigwekar, Jerry Yee, Holly Kramer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

174 Scopus citations

Abstract

Chronic kidney disease–mineral and bone disorder (CKD-MBD) encompasses laboratory and bone abnormalities and vascular calcification and has deleterious effects on clinical outcomes. KDOQI (Kidney Disease Outcomes Quality Initiative), an initiative of the National Kidney Foundation, addressed this issue with the publication of a clinical practice guideline for bone metabolism and disease in CKD in 2003, and 2 years later, a new definition and classification scheme for CKD-MBD was developed following a KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference. The initial KDIGO guideline on CKD-MBD was then published in 2009. New evidence was subsequently reviewed at the 2013 KDIGO Controversies Conference, and in 2017, KDIGO issued a clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of CKD-MBD. This commentary presents the views of the KDOQI CKD-MBD work group convened by the National Kidney Foundation. The KDOQI work group agrees with most of the KDIGO guideline update recommendations, particularly the suggestions regarding bone mineral density testing, joint assessments of longitudinal trends in mineral metabolism markers, and dietary phosphate counseling focused on phosphate additives. However, the KDOQI work group has some concerns about the suggestions related to hypocalcemia and hypercalcemia, phosphate-binder choice, and treatment of abnormal parathyroid hormone concentrations. The overall goal of this commentary is to provide a broad discussion for the US nephrology community regarding CKD-MBD and its diagnosis, prevention, and treatment.

Original languageEnglish (US)
Pages (from-to)737-751
Number of pages15
JournalAmerican Journal of Kidney Diseases
Volume70
Issue number6
DOIs
StatePublished - Dec 2017

Keywords

  • Chronic kidney disease–mineral and bone disorder (CKD-MBD)
  • bone mineral density (BMD)
  • calcium
  • clinical practice guideline
  • dialysis
  • end-stage renal disease (ESRD)
  • evidence-based medicine
  • mineral metabolism
  • nephrology best practices
  • parathyroid hormone (PTH)
  • phosphate
  • phosphate binders
  • renal osteodystrophy

ASJC Scopus subject areas

  • Nephrology

Fingerprint

Dive into the research topics of 'KDOQI US Commentary on the 2017 KDIGO Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)'. Together they form a unique fingerprint.

Cite this