Overview of the 2017 KDIGO CKD-MBD Update: Practice Implications for Adult Hemodialysis Patients.

Judith Beto, Nisha Bhatt, Teresa Gerbeling, Chhaya Patel, Debra Drayer

Journal: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2020;29(1):2-15

PMID: 30150095

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Abstract

Renal dietitians play a pivotal role in the ongoing management of chronic kidney disease in patients on hemodialysis. Awareness of changes to clinical practice guidelines that may impact laboratory parameters associated with chronic kidney disease-mineral and bone disorder is important for optimal patient care. In this article, the Kidney Disease: Improving Global Outcomes 2017 Clinical Practice Guideline Update recommendations related to the treatment of secondary hyperparathyroidism in adults on hemodialysis are reviewed and treatment implications for renal dietitians discussed. Specific attention is given to the integration of updated recommendations such as the use of calcimimetics as part of a combination approach to the existing treatment paradigm. Renal dietitians can directly apply the updated clinical recommendations in the evaluation of diet composition; food additives; medication adherence challenges with phosphate binder type and use and serial monitoring of phosphorus, calcium, and parathyroid hormone levels to inform clinical decisions on treatment options for patients.

Address: Research Associate, Division of Nephrology and Hypertension, Loyola University of Chicago, Maywood, Illinois. Electronic address: [email protected].; US Medical Leader Nephrology, Medical Affairs, Amgen Inc., Thousand Oaks, California.; Renal Dietitian Coordinator, Dialysis Center of Lincoln, Lincoln, Nebraska.; Nutrition Program Manager, Divisional Lead RD, ORCA Division, DaVita Inc., Denver, Colorado.; Senior Regional Medical Liaison Nephrology, Amgen Inc., Thousand Oaks, California.

DOI: 10.1053/j.jrn.2018.05.006