Guidelines for Mineral and Bone Disorder

Guideline Organization

Sub-topic

KDIGO

Diagnosis, Evaluation, Prevention and Treatment of Chronic Kidney Disease related Mineral and Bone Disorders (CKD-MBD)

Published: Kidney Int. (2009) 76 (Suppl 113), S1—S9130

• Diagnosis of CKD-MBD: Biochemical Abnormalities
• Diagnosis of CKD-MBD: Bone
  
• Diagnosis of CKD-MBD: Vascular Calcification
• Treatment of CKD-MBD Targeted at Lowering High Serum Phosphorus and Maintaining Serum Calcium
• Treatment of Abnormal PTH Levels in CKD-MBD
• Treatment of Bone with Bisphosphonates, Other Osteoporosis Medications, and Growth Hormone
• Evaluation and Treatment of Kidney Transplant Bone Disease
  

Summary and Research Recommendations

CARI-Australia

Biochemical and Haematological Targets
(2006)

Vitamin D, Calcimimetics and Phosphate Binders (2006)

Biochemical and Haematological Targets:

• Calcium
• Phosphate
• Calcium x phosphate product  
• Parathyroid hormone

Vitamin D, Calcimimetics and Phosphate Binders:

• Vitamin D in dialysis patients
• Use of calcimimetic drugs
• Use of phosphate binders in kidney disease

CSN-Canada
Chapter 3: Mineral Metabolism
(2006)

Management of Serum Phosphate, Serum Calcium and Parathyroid Hormone (Pg 11of 27)

EBPG-Europe

KDOQI-US

Bone Metabolism and Disease in Chronic Kidney Disease (2003)

Mineral and Bone Disorder

• Evaluation of Calcium and Phosphorus Metabolism
• Assessment of Bone Disease Associated With CKD
• Evaluation of Serum Phosphorus Levels
• Restriction of Dietary Phosphorus in Patients With CKD
• Use of Phosphate Binders in CKD
• Serum Calcium and Calcium-Phosphorus Product
• Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients
• Vitamin D Therapy in CKD Patients
• Active Vitamin D Therapy in Patients With Stages 3 and 4 CKD
• Vitamin D Therapy in Patients on Dialysis (CKD Stage 5)
• Dialysate Calcium Concentrations
• ß2-Microglobulin Amyloidosis
• Aluminum Overload and Toxicity in CKD
• Treatment of Aluminum Toxicity
• Treatment of Bone Disease in CKD
• Hyperparathyroid (High-Turnover) and Mixed (High-Turnover With Mineralization Defect) Bone Disease
• Osteomalacia
• Adynamic Bone Disease
• Parathyroidectomy in Patients With CKD
• Metabolic Acidosis
• Bone Disease in the Kidney Transplant Recipient

The Overall Approach to the Management of Bone Metabolism and Disease in CKD Patients

Bone Metabolism and Disease in Children With CKD 2005

Bone Metabolism and Disease in Children With CKD

• Evaluation of Calcium and Phosphorus Metabolism
• Assessment of Bone Disease Associated with CKD
• Surgical Management of Osteodystrophy
• Target Serum Phosphorus Levels
• Management of Dietary Phosphorus Intake in Children with CKD
• Use of Phosphate Binders in CKD
• Serum Calcium and Calcium-Phosphorus Product
• Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients
• Active Vitamin D Therapy in CKD Patients
• Active Vitamin D Therapy in CKD Patients with CKD Stages 2-4
• Active Vitamin D Therapy in Patients on Dialysis (CKD Stage 5)
• Dialysate Calcium Concentrations

UK-Renal Association

Module B:
Complication of CKD
(2007)

Management of metabolic bone disease (C-MBD)

• Serum calcium in patients with Chronic Kidney Disease
• Serum calcium in Dialysis Patients
• Serum phosphate in patients with CKD stages 3 and 4
• Serum phosphate in dialysis patients
• Serum calcium x phosphate product
• Measurement of Serum Parathyroid Hormone in CKD
• Desired outcome range for Serum Parathyroid Hormone in CKD
• Desired outcome range for Serum Parathyroid Hormone in Dialysis Patients
• Vitamin D in CKD and Dialysis