| [ Summary ] |
The Japanese Society of Dialysis Therapy released guidelines for the treatment of secondary hyperparathyroidism in chronic dialysis patients (JSDT guidelines) in 2006. Recently, chronic kidney disease-mineral bone disorder has been recognized as a systemic disease, which has a greatly deleterious impact on cardiovascular mortality. Accordingly, the JSDT guidelines follow this paradigm shift in disease modality and set a priority not on improvements in bone abnormalities but on improvements in survival of dialysis patients. However, since there has been little evidence gathered in Japan, many JSDT guidelines were established based on evidence from Western countries. Nevertheless, the excellence of dialysis treatment in Japan has been shown by the Dialysis Outcomes and Practice Patterns Study (DOPPS), and Japanese nephrologists should contribute to progress in improving outcomes of dialysis treatment worldwide. From this point of view, the JSDT guidelines could well be used as a stepping stone for further research. Clinical evidence from Japan should be accumulated, to increase the level of the guidelines and to make the guidelines cover a wider range of mineral bone disorders. |