| Theme | Evidence-based clinical guidelines for CKD-MBD in Japan | |
|---|---|---|
| Title | Control serum phosphorus and calcium levels relation to guidelines for treatment of secondary hyperparathyroidism in Japanese hemodialysis patients | |
| Publish Date | 2007/04 | |
| Author | Keitaro Yokoyama | Division of Nephrology and Hypertension, The Jikei University School of Medicine |
| [ Summary ] | In 2006, the Japan Society for Dialysis Therapy published their “Guidelines for Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients”. One of the most important characteristics of these guidelines is that calcium / phosphorus metabolic abnormalities in renal disease patients are not described in relation to bone lesions alone, but are considered pathologies related to arteriosclerosis and overall prognose. Therefore, target serum calcium and phosphorus levels in patients with renal disease are set lower than those in conventional guidelines (target range of serum P = 3.5 - 6.0 mg / dl, target range of serum Ca = 8.4 - 10.0 mg / dl). If target serum calcium / phosphorus levels cannot be attained, administration of active vitamin D for controlling parathyroid hormone and administration of a phosphorus adsorbent, containing calcium, will be more strictly limited than previously (Dosage of calcium carbonate should not exceed 3 g / day). Because these target levels have been set dependent on results of several observational studies, we should perform prospective controlled studies concerning-treatment of secondary hyperpararhyroidism. Moreover, guidelines must be review in light of changes in therapeutic drugs. |
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