| Theme |
Chronic kidney disease-mineral and bone disorder (CKD-MBD) guidelines: Endorsement of the Kidney Disease Improving Global Outcomes (KDIGO) 2017 CKD-MBD Guidelines Update |
| Title |
Parathyroid hormone management for end-stage renal disease |
| Author |
Hirotaka Komaba |
Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine / The Institute of Medical Sciences, Tokai University |
| [ Summary ] |
Secondary hyperparathyroidism is a common complication associated with end-stage renal disease and has a considerable impact on mortality through the development of high-turnover bone disease and vascular calcification. In Japan, secondary hyperparathyroidism is controlled according to the Japanese Society for Dialysis Therapy guideline, and the distribution of parathyroid hormone levels is reported to be much lower than that in other countries. Under these circumstances, based on the emergence of new clinical evidence, the KDIGO issued an updated version of the CKD-MBD guideline in 2017. With this update and the development of new calcimimetics, our treatment strategy for secondary hyperparathyroidism has reached a major turning point. In this review, we outline key aspects of the 2017 KDIGO guideline update regarding the treatment of secondary hyperparathyroidism and discuss its implementation and challenges in Japan. |