Clinical significance of the K/DOQI bone guidelines in Japan

Yokoyama, Keitaro; Katoh, Naohiko; Kubo, Hitoshi; Murai, Seizo; Imamura, Naoko; Shoji, Ryo; Yamamoto, Hiroyasu; Sügimura, Takashi; Nakayama, Masaaki; Takasu, Shinji; Kobayashi, Takashi; Yoshida, Toyohiko; Hosoya, Tatsuo

doi:10.1053/j.ajkd.2004.05.038

Cited by 17 publications

(14 citation statements)

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“…The target ranges of serum phosphate, calcium, and PTH are shown in Table 1 along with those by other guidelines. The target ranges of serum phosphorus and calcium are comparable with those in other guidelines considering the timing of routine blood sampling [29] ; however, a much lower target range has been suggested for PTH. This was not merely because this range was associated with lower mortality but also because the control of serum phosphorus and calcium levels became easier when PTH levels were maintained within this this low range of PTH [27] .…”

Section: Clinical Practice Pattern and Guideline For Ckd-mbd In Japansupporting

confidence: 58%

Chronic Kidney Disease-Mineral and Bone Disorder in Asia

Fukagawa¹,

Komaba²

2017

Kidney Dis

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Background: Chronic kidney disease-mineral and bone disorder (CKD-MBD) is one of the most common complications in patients with CKD. As CKD-MBD is a systemic syndrome, prevention and management should be aimed at achieving better survival and less risk of cardiovascular events and fractures. Summary: Although target ranges for serum markers of mineral metabolism have been proposed in several global or local guidelines, these were mostly based on data from non-Asian patients. Additionally, there remain differences in medical and social systems as well as in economic status, even among Asian countries and areas. Key Message: Asian CKD patient data needs to be analyzed, published, and shared to establish optimal local strategies for CKD-MBD management.

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Section: Clinical Practice Pattern and Guideline For Ckd-mbd In Japansupporting

confidence: 58%

Chronic Kidney Disease-Mineral and Bone Disorder in Asia

Fukagawa¹,

Komaba²

2017

Kidney Dis

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“…We do not, however, consider that our results should be limited to Japanese patients. In Japan, laboratory measurements are usually performed following the longest interdialytic period; thus, the slightly higher target range for serum phosphorus in the JSDT guideline can be considered to be identical to that of the KDOQI guidelines [42]. Also, the upper limit of the target range for serum calcium in the JSDT guideline is slightly higher than that of the KDOQI guidelines; however, recent clinical data suggest that serum calcium in this range is associated with lowest mortality in the US population [43].…”

Section: Discussionmentioning

confidence: 99%

Mineral Metabolism Management in Hemodialysis Patients with Secondary Hyperparathyroidism in Japan: Baseline Data from the MBD-5D

Fukagawa

Komaba²,

Ônishi³

et al. 2011

Am J Nephrol

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Background/Aims: The Mineral and Bone Disorder Outcomes Study for Japanese CKD Stage 5D Patients (MBD-5D) is a multicenter, prospective observational study of hemodialysis patients with secondary hyperparathyroidism (SHPT) in Japan, where the national guideline recommends targets for serum calcium (8.4–10.0 mg/dl), phosphorus (3.5–6.0 mg/dl), and intact parathyroid hormone (PTH) (60–180 pg/ml). Methods: The MBD-5D involved patients who were receiving hemodialysis for more than 3 months and met at least one of the following conditions: having intact PTH levels >180 pg/ml, or receiving intravenous vitamin D receptor activators (VDRAs) or oral VDRA analog. This report describes the baseline characteristics of the study participants and examines factors associated with mineral metabolism controllability. Results: A total of 8,229 patients were registered from 86 facilities as the whole cohort, and 3,276 patients were randomly selected as the subcohort. The severity of SHPT was associated with a lower likelihood of achieving the targets for calcium and phosphorus, whereas patients with a history of parathyroidectomy were more likely to achieve these targets as compared with those who had not undergone surgery despite high PTH levels. The use of 2.5 mEq/l calcium dialysate was also associated with a higher likelihood of achieving the targets compared with the use of 3.0 mEq/l calcium dialysate. Conclusion: The severity of SHPT and the use of dialysate with higher calcium concentration are associated with practical difficulty in managing mineral metabolism in dialysis patients. Further prospective follow-up is needed to confirm our findings and to examine their impact on patient-level outcomes.

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“…The hazard ratio for serum calcium between 10.0 and 10.9 mg/dL was 1.098 (95% confidence interval 1.020–1.182, P = 0.0129) when the reference serum calcium was set at 9.0–9.9 mg/dL. Although some cohort studies have shown that patient survival is better with lower serum calcium levels (9–11), Nakai's analysis in Japan could not show better survival when serum calcium was lower than the target range.…”

Section: Background and Rationalementioning

confidence: 91%

Clinical Practice Guideline for the Management of Secondary Hyperparathyroidism in Chronic Dialysis Patients

2008

Ther Apher Dial

153

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Clinical significance of the K/DOQI bone guidelines in Japan

Cited by 17 publications

References 0 publications

Chronic Kidney Disease-Mineral and Bone Disorder in Asia

Chronic Kidney Disease-Mineral and Bone Disorder in Asia

Mineral Metabolism Management in Hemodialysis Patients with Secondary Hyperparathyroidism in Japan: Baseline Data from the MBD-5D

Clinical Practice Guideline for the Management of Secondary Hyperparathyroidism in Chronic Dialysis Patients

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