| Theme | The concepts of the new JSDT clinical guideline on CKD-MBD | |
|---|---|---|
| Title | Evaluation and management of parathyroid function | |
| Publish Date | 2013/01 | |
| Author | Takatoshi Kakuta | Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine |
| [ Summary ] | JSDT clinical practice guideline for the management of CKD-mineral and bone disorders in chronic dialysis patients was originally published in Japan in 2012. It is desirable to maintain intact PTH levels at 60 pg/mL or higher and 240 pg/mL or lower to provide the best possible survival rates. Alternatively, it is desirable to maintain whole PTH levels at 35 pg/mL or higher and levels at 150 pg/mL or lower. When PTH levels continue to exceed the upper limits of the target control range, medical treatments such as improving P and Ca metabolism and the use of active vitamin D preparations or cinacalcet hydrochloride should be implemented first to reduce PTH levels. When serum P, Ca, and PTH levels cannot be simultaneously maintained in target control ranges through medical treatment, we must consider indications for parathyroid intervention. |
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