What is the treatment for abnormal mineral homeostasis in chronic kidney disease (CKD)?

Updated: Oct 26, 2020
  • Author: Pradeep Arora, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Treatment of abnormal mineral homeostasis in patients with CKD includes the following [75] :

  • Lowering high serum phosphorus levels
  • Maintaining serum calcium levels
  • Lowering serum parathyroid hormone levels
  • Providing osteoporosis prophylaxis

The Kidney Disease: Improving Global Outcomes (KDIGO) Implementation Task Force updated its guidelines on the management of CKD–mineral and bone disorder in 2017. [75]  The guidelines, which were issued after weighing the quality and the depth of evidence, when available, propose a common-sense approach to the evaluation and treatment of mineral and bone disorder in different stages of CKD.

The National Kidney Foundation convened a work group to provide a US perspective on the KDOQI CKD-MBD guidelines. While agreeing with most of the KDIGO recommendations, the work group had some concerns about the suggestions related to hypocalcemia and hypercalcemia, phosphate-binder choice, and treatment of abnormal parathyroid hormone concentrations. [76]


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