Chronic Kidney Disease

KDIGO Updates 2009 CKD-MBD Guidelines

The Kidney Disease: Improving Global Outcomes (KDIGO) group recently updated its guideline for the management of chronic kidney disease-mineral and bone disorder for the first time since 2009.

The update was made following a review of literature published through September 2015, with supplements added from targeted searches of literature published through February 2017.
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A total of 15 recommendations were revised. Among the new recommendations are the following:

  • Bone mineral density (BMD) testing is recommended for patients with CKD G3a to G5D with evidence of CKD-MBD and/or risk factors for osteoporosis in order to assess fracture risk.
  • A bone biopsy is a reasonable option for patients with CKD G3a to G5D if knowledge of the type of renal osteodystrophy will affect treatment decisions.
  • Treatments of CKD-MBD in patients with CKD G3a to G5D should be based on consecutive assessments of phosphate, calcium, and PTH levels, considered together.

For the full guideline update, click here.

—Christina Vogt

Reference:

Ketteler M, Block GA, Evenepoel P, et al. 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 [Published online February 20, 2018]. Ann Intern Med. doi:10.7326/M17-2640.