KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD).
KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD).
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DOI：
10.1038/ki.2009.188
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发表时间：
2009-08-01
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2009年肾脏疾病：改善全球结局（KDIGO）关于慢性肾脏疾病-矿物质和骨骼疾病（CKD-MBD）管理的临床实践指南旨在帮助医生照顾慢性透析治疗或肾移植的3-5期CKD成人和儿童。该指南包含对CKD-MBD异常的评估和治疗建议。CKD-MBD的疾病概念是基于之前的KDIGO共识会议。所考虑的测试是那些与检测和监测实验室，骨骼和心血管异常有关的测试。考虑的治疗是治疗3-5D和1- 5 T期CKD患者的高磷酸盐血症、高甲状旁腺激素和骨病的干预措施。指南制定过程遵循循证方法，治疗建议基于相关治疗试验的系统评价。测试建议使用基于诊断准确性或风险预测的证据，并将其间接与如何通过更好的检测，评估或治疗疾病为患者实现更好的结果联系起来。对证据质量和建议强度的严格评估遵循GRADE方法。当问题不适合系统性文献综述时，提供未分级声明。证据的局限性，特别是缺乏明确的临床结果试验，进行了讨论，并为未来的研究提供了建议。
The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on the management of chronic kidney disease-mineral and bone disorder (CKD-MBD) is intended to assist the practitioner caring for adults and children with CKD stages 3-5, on chronic dialysis therapy, or with a kidney transplant. The guideline contains recommendations on evaluation and treatment for abnormalities of CKD-MBD. This disease concept of CKD-MBD is based on a prior KDIGO consensus conference. Tests considered are those that relate to the detection and monitoring of laboratory, bone, and cardiovascular abnormalities. Treatments considered are interventions to treat hyperphosphatemia, hyperparathyroidism, and bone disease in patients with CKD stages 3-5D and 1-5T. The guideline development process followed an evidence based approach and treatment recommendations are based on systematic reviews of relevant treatment trials. Recommendations for testing used evidence based on diagnostic accuracy or risk prediction and linked it indirectly with how this would be expected to achieve better outcomes for patients through better detection, evaluation or treatment of disease. Critical appraisal of the quality of the evidence and the strength of recommendations followed the GRADE approach. An ungraded statement was provided when a question did not lend itself to systematic literature review. Limitations of the evidence, especially the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research.