Chronic kidney disease–mineral and bone disorder: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Сonference
https://doi.org/10.28996/2618-9801-2025-1-20-37
Abstract
In 2017, Kidney Disease: Improving Global Outcomes (KDIGO) published a Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKDMBD). Since then, new lines of evidence have been published related to evaluating disordered mineral metabolism and bone quality and turnover, identifying and inhibiting vascular calcification, targeting vitamin D levels, and regulating parathyroid hormone. For an in-depth consideration of the new insights, in October 2023, KDIGO held a Controversies Conference on CKD-MBD: Progress and Knowledge Gaps Toward Personalizing Care. Participants concluded that the recommendations in the 2017 CKD-MBD guideline remained largely consistent with the available evidence. However, the framework of the 2017 Guideline, with 3 major sections–biochemical abnormalities in mineral metabolism; bone disease; and vascular calcification–may no longer best reflect currently available evidence related to diagnosis and treatment. Instead, future guideline efforts could consider mineral homeostasis and deranged endocrine systems in adults within a context of 2 clinical syndromes: CKD-associated osteoporosis, encompassing increased fracture risk in patients with CKD; and CKD-associated cardiovascular disease, including vascular calcification and structural abnormalities, such as valvular calcification and left ventricular hypertrophy. Participants emphasized that the complexity of bone and cardiovascular manifestations of CKD-MBD necessitates personalized approaches to management.
About the Authors
M. Ketteler
Department of General Internal Medicine and Nephrology, Robert-Bosch-Hospital
Germany
Germany
Markus Ketteler.
General Internal Medicine and Nephrology, Robert-Bosch-Hospital, Auerbachstrasse 110, 70376 Stuttgart
P. Evenepoel
Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, Katholieke Universiteit Leuven; Department of Nephrology and Renal Transplantation, University Hospitals Leuven
Belgium
Belgium
Pieter Evenepoel.
Leuven
R. M. Holden
Department of Medicine, Queen’s University
Canada
Canada
Rachel M. Holden.
Kingston, Ontario
T. Isakova
Division of Nephrology and Hypertension, Department of Medicine and Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine
United States
United States
Tamara Isakova.
Chicago, Illinois
H. S. Jørgensen
Department of Nephrology, Aalborg University Hospital; Department of Clinical Medicine, Aarhus University
Denmark
Denmark
Hanne Skou Jørgensen.
Aalborg; Aarhus
H. Komaba
Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine
Japan
Japan
Hirotaka Komaba.
Isehara
T. L. Nickolas
Department of Medicine, Division of Bone and Mineral Diseases, Washington University School of Medicine
United States
United States
Thomas L. Nickolas.
St Louis, Missouri
S. Sinha
Renal Directorate, Northern Care Alliance NHS Foundation Trust; Manchester Academic Health Sciences Centre, University of Manchester
United Kingdom
United Kingdom
Smeeta Sinha.
Salford; Manchester
M. G. Vervloet
Department of Nephrology, Radboud University Medical Center
Netherlands
Netherlands
Marc G. Vervloet.
Nijmegen
M. Cheung
KDIGO
Belgium
Belgium
Michael Cheung.
Brussels
J. M. King
KDIGO
Belgium
Belgium
Jennifer M. King.
Brussels
M. E. Grams
Department of Medicine, New York University Langone School of Medicine
United States
United States
Morgan E. Grams.
New York, New York
M. Jadoul
Cliniques Universitaires Saint Luc, Université Catholique de Louvain
Belgium
Belgium
Michel Jadoul.
Brussels
R. M.A. Moyses
Laboratório de Fisiopatologia Renal (LIM 16), Nephrology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Universidade de São Paulo
Brazil
Brazil
Rosa M.A. Moysés.
Rua Iperoig, 690 ap 121, São Paulo SP 05016-000
Participants Conference
Additional Conference Participants are listed in the Appendix.
Review
For citations:
Ketteler M., Evenepoel P., Holden R.M., Isakova T., Jørgensen H.S., Komaba H., Nickolas T.L., Sinha S., Vervloet M.G., Cheung M., King J.M., Grams M.E., Jadoul M., Moyses R.M., Conference P. Chronic kidney disease–mineral and bone disorder: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Сonference. Nephrology and Dialysis. 2025;27(1):20-37. (In Russ.) https://doi.org/10.28996/2618-9801-2025-1-20-37
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