Chronic Kidney Disease-Mineral and Bone Disorder, Vitamin D Deficiency, and Secondary Hyperparathyroidism

  • Mingxia XiongEmail author


Chronic kidney disease-mineral and bone disorder (CKD-MBD) encompasses laboratory and bone abnormalities and vascular or other soft tissue calcification and has adverse effects on clinical prognosis. The 2017 KDIGO clinical practice guideline recommends monitoring serum levels of calcium, phosphate, PTH, and alkaline phosphatase activity beginning in CKD G3a. Treatments of CKD-MBD should be based on serial assessments of phosphate, calcium, and PTH levels, considered together. In patients with CKD G3a–G5D with severe hyperparathyroidism who fail to respond to pharmacological therapy, we suggest parathyroidectomy. The ambiguity and lack of unequivocally actionable recommendations highlight potential challenges for implementation and underscore the need for future research in this important area.


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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Centre for Kidney DiseaseSecond Affiliated Hospital, Nanjing Medical UniversityNanjingChina

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