For Korean
dialysis patients,
chronic kidney disease-
mineral bone disorder is a serious burden because of cardiovascular calcification and
mortality. However, recent epidemiologic data have demonstrated that many
patients undergoing
maintenance hemodialysis are out of the target ranges of
serum calcium,
phosphorus, and intact
parathyroid hormone. Thus, we felt the necessity for the development of practical recommendations to treat abnormal
serum phosphorus,
calcium, and iPTH in
dialysis patients. In this
paper, we briefly
comment on the measurement of
serum calcium,
phosphorus, iPTH,
dialysate calcium concentration,
dietary phosphorus restriction, use of
phosphate binders, and medical and surgical options to correct
secondary hyperparathyroidism. In particular, for the optimal management of
secondary hyperparathyroidism, we suggest a simplified medication
adjustment according to certain ranges of
serum phosphorus and
calcium. Large-scale, well-designed clinical studies are required to support our
strategies to control
chronic kidney disease-
mineral bone disorder in this country. Based on such data, our practice guidelines could be established and better long-term outcomes should be anticipated in our
dialysis patients.