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2015 ; 34
(1
): 4-12
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Management of chronic kidney disease-mineral and bone disorder: Korean working
group recommendations
#MMPMID26484013
Hwang E
; Choi BS
; Oh KH
; Kwon YJ
; Kim GH
Kidney Res Clin Pract
2015[Mar]; 34
(1
): 4-12
PMID26484013
show ga
For Korean dialysis patients, chronic kidney disease-mineral bone disorder is a
serious burden because of cardiovascular calcification and mortality. However,
recent epidemiologic data have demonstrated that many patients undergoing
maintenance hemodialysis are out of the target ranges of serum calcium,
phosphorus, and intact parathyroid hormone. Thus, we felt the necessity for the
development of practical recommendations to treat abnormal serum phosphorus,
calcium, and iPTH in dialysis patients. In this paper, we briefly comment on the
measurement of serum calcium, phosphorus, iPTH, dialysate calcium concentration,
dietary phosphorus restriction, use of phosphate binders, and medical and
surgical options to correct secondary hyperparathyroidism. In particular, for the
optimal management of secondary hyperparathyroidism, we suggest a simplified
medication adjustment according to certain ranges of serum phosphorus and
calcium. Large-scale, well-designed clinical studies are required to support our
strategies to control chronic kidney disease-mineral bone disorder in this
country. Based on such data, our practice guidelines could be established and
better long-term outcomes should be anticipated in our dialysis patients.