| [ Summary ] |
The process of developing target ranges for serum phosphate (P), adjusted calcium (Ca) and parathyroid hormone (PTH) levels in the Japanese CKD-MBD guidelines is discussed. The attainment of target levels leading to improved prognoses in hemodialysis patients is also discussed. By analyzing data from the Japanese Renal Data Registry, target ranges for serum P, corrected Ca and PTH were determined to be 3.5-6.0 mg/dl, 8.4-10.0 mg/dl, 60-240 pg/ml, respectively. The adequacy of "Clinical Practice Guidelines for Secondary Hyperparathyroidism in 2006" are also verified. Patients who achieved the target levels, especially those who maintained those levels, often had good prognoses. These results suggest both the importance and validity of the CKD-MBD guidelines. |