KDOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease
THE OVERALL APPROACH TO THE MANAGEMENT OF BONE METABOLISM AND DISEASE IN CKD PATIENTS
The KDOQI Bone Metabolism and Disease Guidelines (1 through 16) address individual issues of bone metabolism and disease in CKD patients. The approach to the problems of these patients is not easily amenable to a protocol, as all of the variables involved (levels of calcium, phosphorus, vitamin D, PTH, and total CO2) affect each other. The following 2 algorithms allow for an integrated approach for the care of bone metabolism and disease in CKD patients in Stages 3 and 4 (Algorithm 10) and in CKD patients Stage 5 (Algorithm 11). However, it should be emphasized that the care of CKD patients with bone disease requires frequent assessment of the various parameters underlying the derangements in bone metabolism and bone disease, and frequent evaluation of the therapies as detailed in Guidelines 1 through 16 are necessary.
Algorithm 10. CKD Stages 3 and 4.
Algorithm 11. CKD Stage 5 (on dialysis).
© 2003 National Kidney Foundation, Inc.