scholarly journals Revisiting KDIGO clinical practice guideline on chronic kidney disease—mineral and bone disorder: a commentary from a Kidney Disease: Improving Global Outcomes controversies conference

2015 ◽  
Vol 87 (3) ◽  
pp. 502-508 ◽  
Author(s):  
Markus Ketteler ◽  
Grahame J. Elder ◽  
Pieter Evenepoel ◽  
Joachim H. Ix ◽  
Sophie A. Jamal ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Mineral And Bone Disorder ◽  
Bone Disorder

CHRONIC KIDNEY DISEASE AND MINERAL BONE DISORDER AS RECOMMEND BY KDIGO 2017

2017 ◽  
pp. 19-31
Author(s):  
Thanh Minh Nguyen ◽  
Tam Vo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Transplantation ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Kidney Diseases ◽  
Target Range ◽  
Mineral And Bone Disorder ◽  
Bone Disorder

KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD- MBD) is used to assist practitioners on caring for patients with chronic kidney diseases. New evidence has changed significantly clinical guidelines of dialysis and kidney transplantation. This evaluation material highlights core aspects of KDIGO 2017 Clinical Practice Guideline Update for CKD-MBD, including the reasons why the old version was modified. The topics of the material consists of updated guidelines related to the diagnosis of bone abnormalities in patients with Mineral and Bone Disorder (MBD), treating CKD-MBD by lowering serum phosphate levels to the target range and maintaining stable calcium levels, the treatment of abnormalities of parathyroid hormone in patients suffering from CKD-MBD, managing bone disorders by osteoporosis drugs, the treatment and evaluation after kidney transplantation. Key words: Chronic kidney disease; mineral and bone disorder.

scholarly journals Evidence in chronic kidney disease–mineral and bone disorder guidelines: is it time to treat or time to wait?

2020 ◽  
Vol 13 (4) ◽  
pp. 513-521 ◽  
Author(s):  
Jordi Bover ◽  
Pablo Ureña-Torres ◽  
Silvia Mateu ◽  
Iara DaSilva ◽  
Silvia Gràcia ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Evidence Based ◽  
Mineral And Bone Disorder ◽  
Bone Disorder ◽  
Based Medicine

Abstract Chronic kidney disease–mineral and bone disorder (CKD–MBD) is one of the many important complications associated with CKD and may at least partially explain the extremely high morbidity and mortality among CKD patients. The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline document was based on the best information available at that time and was designed not only to provide information but also to assist in decision-making. In addition to the international KDIGO Work Group, which included worldwide experts, an independent Evidence Review Team was assembled to ensure rigorous review and grading of the existing evidence. Based on the evidence from new clinical trials, an updated Clinical Practice Guideline was published in 2017. In this review, we focus on the conceptual and practical evolution of clinical guidelines (from eMinence-based medicine to eVidence-based medicine and ‘living’ guidelines), highlight some of the current important CKD–MBD-related changes, and underline the poor or extremely poor level of evidence present in those guidelines (as well as in other areas of nephrology). Finally, we emphasize the importance of individualization of treatments and shared decision-making (based on important ethical considerations and the ‘best available evidence’), which may prove useful in the face of the uncertainty over the decision whether ‘to treat’ or ‘to wait’.

scholarly journals Canadian Society of Nephrology Commentary on the Kidney Disease Improving Global Outcomes 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder

2020 ◽  
Vol 7 ◽  
pp. 205435812094427
Author(s):  
Rachel M. Holden ◽  
Reem A. Mustafa ◽  
R. Todd Alexander ◽  
Marisa Battistella ◽  
Micheli U. Bevilacqua ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Mineral And Bone Disorder ◽  
Bmd Testing ◽  
Prevention And Treatment ◽  
Bone Disorder

Purpose of review: (1) To provide commentary on the 2017 update to the Kidney Disease Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD); (2) to apply the evidence-based guideline update for implementation within the Canadian health care system; (3) to provide comment on the care of children with chronic kidney disease (CKD); and (4) to identify research priorities for Canadian patients. Sources of information: The KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of CKD-MBD. Methods: The commentary committee co-chairs selected potential members based on their knowledge of the Canadian kidney community, aiming for wide representation from relevant disciplines, academic and community centers, and different geographical regions. Key findings: We agreed with many of the recommendations in the clinical practice guideline on the diagnosis, evaluation, prevention, and treatment of CKD-MBD. However, based on the uncommon occurrence of abnormalities in calcium and phosphate and the low likelihood of severe abnormalities in parathyroid hormone (PTH), we recommend against screening and monitoring levels of calcium, phosphate, PTH, and alkaline phosphatase in adults with CKD G3. We suggest and recommend monitoring these parameters in adults with CKD G4 and G5, respectively. In children, we agree that monitoring for CKD-MBD should begin in CKD G2, but we suggest measuring ionized calcium, rather than total calcium or calcium adjusted for albumin. With regard to vitamin D, we suggest against routine screening for vitamin D deficiency in adults with CKD G3-G5 and G1T-G5T and suggest following population health recommendations for adequate vitamin D intake. We recommend that the measurement and management of bone mineral density (BMD) be according to general population guidelines in CKD G3 and G3T, but we suggest against routine BMD testing in CKD G4-G5, CKD G4T-5T, and in children with CKD. Based on insufficient data, we also recommend against routine bone biopsy in clinical practice for adults with CKD or CKD-T, or in children with CKD, although we consider it an important research tool. Limitations: The committee relied on the evidence summaries produced by KDIGO. The CSN committee did not replicate or update the systematic reviews.

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