[Update 2017 of the KDIGO guidelines on Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). What are the real changes?]

Abstract

Guidelines for the assessment, diagnosis and therapy of the alterations that characterize the CKD-MBD are an important support in the clinical practice of the nephrologist. Compared to the KDIGO guidelines published in 2009, the 2017 update made changes on some topics on which there was previously no strong evidence both in terms of diagnosis and therapy. The recommendations include the diagnosis of bone anomalies in CKD-MBD and the treatment of mineral metabolism abnormalities with particular regard to hyperphosphataemia, calcium levels, secondary hyperparathyroidism and anti-resorptive therapies. The Italian Study Group on Mineral Metabolism, in reviewing the 2017 recommendations, aimed to assess the weight of the evidence that led to this update. In fact, on some topics there has not been a substantial difference on the degree of evidence compared to the previous guidelines. The Italian Study Group emphasizes the points that may still reserve critical issues, including interpretation, and invites an evaluation that is articulated and personalized for each patient.

• Authors: Marzia Pasquali, Antonio Bellasi, Giuseppe Cianciolo, Carlo Massimetti, Maria Cristina Mereu, Luigi Morrone, Vincenzo Panuccio, A nome del GdS Elementi Traccia e Metabolismo Minerale della Società Italiana di Nefrologia
• Journal: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia (G Ital Nefrol) Vol. 35 Issue 3 (May 2018) ISSN: 1724-5990 [Electronic] Italy
• PMID: 29786179 (Publication Type: Practice Guideline)
• Copyright: Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

Chemical References

• Adrenal Cortex Hormones
• Bone Density Conservation Agents
• Dialysis Solutions
• Vitamin D
• Calcium

Topics

• Adrenal Cortex Hormones (adverse effects)
• Biopsy
• Bone Demineralization, Pathologic (etiology, physiopathology, therapy)
• Bone Density
• Bone Density Conservation Agents (therapeutic use)
• Bone Resorption (etiology, prevention & control)
• Bone and Bones (pathology)
• Calcium (analysis)
• Chronic Kidney Disease-Mineral and Bone Disorder (diagnostic imaging, physiopathology, therapy)
• Contraindications, Drug
• Dialysis Solutions (chemistry)
• Humans
• Hypercalcemia (etiology, prevention & control, therapy)
• Hyperparathyroidism, Secondary (drug therapy, etiology, physiopathology)
• Hyperphosphatemia (diet therapy, drug therapy, etiology)
• Renal Insufficiency, Chronic (complications, metabolism)
• Vitamin D (therapeutic use)