Mission Statement:

To improve the care and outcomes of kidney disease
patients worldwide through promoting coordination,
collaboration and integration of initiatives to develop
and implement clinical practice guidelines.

Tables, figures, and algorithms
TABLES
S4 Table 1. KDIGO classification of CKD–MBD and renal osteodystrophy
S10 Table 2. Grading of recommendations
S12 Table 3. Screening criteria for systematic review topics
S13 Table 4. Questions for topics not related to treatments
S15 Table 5. Literature search yield of primary articles for systematic review topics
S18 Table 6. Grading of study quality for an outcome
S19 Table 7. GRADE system for grading quality of evidence for an outcome
S19 Table 8. Final grade for overall quality of evidence
S19 Table 9. Balance of benefits and harm
S20 Table 10. Implications of the strength of a recommendation
S20 Table 11. Determinants of the strength of a recommendation
S26 Table 12. Suggested frequencies of serum calcium, phosphorus, and PTH measurements according to CKD stage
S27 Table 13. Sources and magnitude of the variation in the measurement of serum calcium, phosphorus, PTH, and vitamin D sterols
S30 Table 14. Vitamin D2 and D3 and their derivatives
S36 Table 15. Changes in bone histomorphometric measurements from patients in placebo groups of clinical trials or longitudinal studies
S40 Table 16. Relationship between fractures and PTH in patients with CKD–MBD
S41 Table 17. Positive predictive value for iPTH and b-ALP to predict bone turnover in patients with CKD stage 5
S41 Table 18. Correlation between PTH or other serum markers and BMD
S52 Table 19. Phosphate-binding compounds
S63 Table 20. RCTs of phosphate binders in children with CKD
S63 Table 21. Summary table of RCTs examining the treatment of CKD–MBD with sevelamer-HCl vs calcium-containing phosphate binders in CKD stages 3–5—description of population at baseline
S63 Table 22. Summary table of RCTs examining the treatment of CKD–MBD with sevelamer-HCl vs calcium-containing phosphate binders in CKD stages 3–5—intervention and results
S64 Table 23. Evidence matrix for sevelamer-HCl vs calcium-containing phosphate binders in CKD stage 5D
S65 Table 24. Evidence profile for the treatment of CKD–MBD with sevelamer-HCl vs calcium-containing phosphate binders in CKD stage 5D
S67 Table 25. Evidence matrix for lanthanum carbonate vs other phosphate binders in CKD stage 5D
S68 Table 26. Evidence profile of lanthanum carbonate vs other phosphate binders in CKD stages 5D
S69 Table 27. Summary table of RCT examining alternate HD regimens in CKD stage 5D—description of population at baseline
S69 Table 28. Summary table of RCT examining alternate HD regimens in CKD stage 5D—intervention and results
S69 Table 29. Adverse events of alternate HD regimens in CKD stage 5D
S82 Table 30. RCTs of calcitriol or other vitamin D analogs in children with CKD
S83 Table 31. Evidence matrix of calcitriol or vitamin D analogs vs placebo in CKD stages 3–5
S84 Table 32. Evidence profile of treatment of CKD–MBD with calcitriol or vitamin D analogs vs placebo in CKD stages 3–5
S85 Table 33. Evidence matrix for calcitriol vs vitamin D analogs in CKD stage 5D
S86 Table 34. Evidence profile for calcitriol vs vitamin D analogs in CKD stage 5D
S87 Table 35. Evidence matrix for calcimimetics in CKD stage 5D
S88 Table 36. Evidence profile for calcimimetics in CKD stage 5D
S98 Table 37. Evidence matrix of bisphosphonates vs placebo/control in CKD stages 3–5
S99 Table 38. Evidence profile of bisphosphonates vs placebo/control in CKD stages 3–5
S106 Table 39. RCTs of treatments for CKD–MBD in children with CKD stages 1–5T
S107 Table 40. Evidence matrix of calcitriol or vitamin D analogs vs placebo or calcium alone in CKD stages 1–5T
S108 Table 41. Evidence profile of calcitriol or vitamin D analogs vs placebo or calcium alone in CKD stages 1–5T
S109 Table 42. Evidence matrix of bisphosphonates vs control in CKD stages 1–5T
S110 Table 43. Evidence profile for the treatment of CKD–MBD with bisphosphonates vs control in CKD stages 1–5T
S111 Table 44. Summary of cumulative evidence matrix with patient-centered outcomes, other surrogate outcomes, and biochemical outcomes
S112 Table 45. Cumulative evidence matrix for all treatment studies by outcome
S113 Table 46. Grading of recommendations
 
FIGURES
S5 Figure 1. Interpreting a surrogate outcome trial
S10 Figure 2. Evidence model
S17 Figure 3. Parameters of bone turnover, mineralization, and volume
S24 Figure 4. Prevalence of abnormal mineral metabolism in CKD
S25 Figure 5. Changes in serum calcium, phosphorus, and iPTH with time in hemodialysis patients of DOPPS countries
S28 Figure 6. PTH assays
S35 Figure 7. Prevalence of types of bone disease as determined by bone biopsy in patients with CKD–MBD
S35 Figure 8. Prevalence of histologic types of renal osteodystrophy in children with CKD stages 5–5D
S35 Figure 9. Types of renal osteodystrophy before and after 1995
S36 Figure 10. Prevalence of bone histology types by symptoms in patients with CKD stage 5D receiving HD treatment
S37 Figure 11. Distribution of osteoporosis, osteopenia, and normal bone density by creatinine clearance in general
US population
S38 Figure 12. Overlap between osteoporosis and CKD stages 3–4
S38 Figure 13. Bone mineral density in patients with CKD stage 5D
S40 Figure 14. Correlation coefficients between bone formation rate as seen on bone biopsies and serum markers of PTH, bone-specific ALP (BAP), osteocalcin (OC), and collagen cross-linking molecules (x-link) in patients with CKD stages 5–5D
S76 Figure 15. Comparison of PTH levels to underlying bone histology in chronic hemodialysis patients
S77 Figure 16. Risk of all-cause mortality associated with combinations of baseline serum phosphorus and calcium categories by PTH level