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A Japanese approach for CKD-MBD
Keitaro Yokoyama1, Masatomo Taniguchi2, Masafumi Fukagawa3
1Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine , Tokyo, Japan.
Insights
The revised 2012 Japanese guideline for chronic kidney disease-mineral and bone disorder (CKD-MBD) incorporates new therapies for secondary hyperparathyroidism. This update aims to improve patient management and understanding of CKD-MBD in Japan.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- CKD-mineral and bone disorder (CKD-MBD) significantly contributes to cardiovascular complications in chronic kidney disease (CKD) patients.
- The previous 2008 guideline improved understanding and management of secondary hyperparathyroidism in CKD.
- New therapeutic options and evidence have emerged since the last guideline publication.
Approach:
- Revision of the 2008 Japanese Society for Dialysis Therapy clinical practice guideline.
- Inclusion of new policies based on recent therapeutic modalities and evidence.
- Presentation of the updated guideline text and discussion of CKD-MBD's clinical significance in Japan.
Key Points:
- CKD-MBD encompasses bone and mineral metabolism abnormalities and vascular calcification.
- Secondary hyperparathyroidism management is crucial for reducing cardiovascular risk in CKD.
- The updated guideline reflects advancements in therapeutic interventions for Japanese dialysis patients.
Conclusions:
- The 2012 guideline provides updated recommendations for managing secondary hyperparathyroidism in CKD-MBD.
- This revision aims to enhance clinical practice and patient outcomes in Japan.
- Understanding the clinical significance of CKD-MBD is vital for comprehensive patient care.
Abstract:
Disturbances in mineral and bone metabolism have a critical role in the pathogenesis of cardiovascular complications in patients with chronic kidney disease (CKD). The term 'renal osteodystrophy' has recently been replaced by 'CKD-mineral and bone disorder (CKD-MBD)', which includes abnormalities in bone and mineral metabolism and vascular calcification. The Japanese Society for Dialysis Therapy clinical practice guideline for the management of secondary hyperparathyroidism in chronic dialysis patients was originally published in Japanese in 2006, then in English in 2008. During the past 5 years, this first guideline has contributed to a considerably better understanding and control of secondary hyperparathyroidism in CKD patients by physicians, other medical professionals, and the patients themselves. However, since its publication several new therapeutic modalities have become available for Japanese dialysis patients, which added more evidence to this area. Thus, we revised the guideline to include several new policies, and the new guideline was published in Japanese in 2012. This article contains the new guideline text, and clinical significance of CKD-MBD in Japan.
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