Diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder

Synopsis of the kidney disease: Improving global outcomes 2017 clinical practice guideline update

Markus Ketteler, Geoffrey A. Block, Pieter Evenepoel, Masafumi Fukagawa, Charles A. Herzog, Linda McCann, Sharon Moe, Rukshana Shroff, Marcello A. Tonelli, Nigel D. Toussaint, Marc G. Vervloet, Mary B. Leonard

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Description: 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) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update and the original publication are intended to assist practitioners caring for adults with CKD and those receiving long-term dialysis. Methods: Development of the guideline update followed an explicit process of evidence review and appraisal. The approach adopted by the Work Group and the evidence review team was based on systematic reviews of relevant trials, appraisal of the quality of the evidence, and rating of the strength of recommendations according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Searches of the English-language literature were conducted through September 2015 and were supplemented with targeted searches through February 2017. Final modification of the guidelines was informed by a public review process involving numerous stakeholders, including patients, subject matter experts, and industry and national organizations. Recommendations: The update process resulted in the revision of 15 recommendations. This synopsis focuses primarily on recommendations for diagnosis of and testing for CKD-MBD and treatment of CKD-MBD that emphasizes decreasing phosphate levels, maintaining calcium levels, and addressing elevated parathyroid hormone levels in adults with CKD stage G3a to G5 and those receiving dialysis. Key elements include basing treatment on trends in laboratory values rather than a single abnormal result and being cautious to avoid hypercalcemia when treating secondary hyperparathyroidism.

Original languageEnglish (US)
Pages (from-to)422-430
Number of pages9
JournalAnnals of Internal Medicine
Volume168
Issue number6
DOIs
StatePublished - Mar 20 2018

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Chronic Kidney Disease-Mineral and Bone Disorder
Kidney Diseases
Practice Guidelines
Guidelines
Dialysis
Secondary Hyperparathyroidism
Hypercalcemia
Therapeutics
Parathyroid Hormone
Publications
Industry
Language
Phosphates
Calcium

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder : Synopsis of the kidney disease: Improving global outcomes 2017 clinical practice guideline update. / Ketteler, Markus; Block, Geoffrey A.; Evenepoel, Pieter; Fukagawa, Masafumi; Herzog, Charles A.; McCann, Linda; Moe, Sharon; Shroff, Rukshana; Tonelli, Marcello A.; Toussaint, Nigel D.; Vervloet, Marc G.; Leonard, Mary B.

In: Annals of Internal Medicine, Vol. 168, No. 6, 20.03.2018, p. 422-430.

Research output: Contribution to journalReview article

Ketteler, M, Block, GA, Evenepoel, P, Fukagawa, M, Herzog, CA, McCann, L, Moe, S, Shroff, R, Tonelli, MA, Toussaint, ND, Vervloet, MG & Leonard, MB 2018, 'Diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder: Synopsis of the kidney disease: Improving global outcomes 2017 clinical practice guideline update', Annals of Internal Medicine, vol. 168, no. 6, pp. 422-430. https://doi.org/10.7326/M17-2640
Ketteler, Markus ; Block, Geoffrey A. ; Evenepoel, Pieter ; Fukagawa, Masafumi ; Herzog, Charles A. ; McCann, Linda ; Moe, Sharon ; Shroff, Rukshana ; Tonelli, Marcello A. ; Toussaint, Nigel D. ; Vervloet, Marc G. ; Leonard, Mary B. / Diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder : Synopsis of the kidney disease: Improving global outcomes 2017 clinical practice guideline update. In: Annals of Internal Medicine. 2018 ; Vol. 168, No. 6. pp. 422-430.
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