| Theme | The concepts of the new JSDT clinical guideline on CKD-MBD | |
|---|---|---|
| Title | Basic manner in the control of CKD-MBD in dialysis patients | |
| Publish Date | 2013/01 | |
| Author | Fumihiko Koiwa | Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital |
| Author | Nobuharu Kaneshima | Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital |
| [ Summary ] | The policy of the previous version utilizing the result of blood examinations measured routinely has been kept on as a basic manner. Serum P, Ca, albumin (Alb) levels, PTH, and alkaline phosphate (ALP) concentrations are measured as routine examinations related to CKD-MBD, serum Alb are used for Ca correction. It is important to ascertain modality of assay including sample collection, drug adherence or the timing from taking drug to blood sampling. Blood sampling is conducted at the beginning of the first dialysis session in each week, pathologic evaluation or determining of the therapeutic plans should be determined based on the trends of several measurements, not by single result of laboratory value. It is reasonable that serum P and Ca levels are measured at least once or twice a month, and PTH is usually measured once every three months. However, these examinations are measured more frequently (PTH is measured once a month) until the values stabilize, if the serum P or Ca values deviate markedly from target ranges or if there is a high risk of deviation, taking active therapy. |
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