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NDT Advance Access originally published online on February 11, 2009
Nephrology Dialysis Transplantation 2009 24(5):1358-1361; doi:10.1093/ndt/gfp025
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Taking aim at targets*

Suetonia C. Palmer1,2, Jonathan C. Craig2,3 and Giovanni F. M. Strippoli2–5

1 Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand 2 Cochrane Renal Group 3 NHMRC Centre for Clinical Research Excellence in Renal Medicine, School of Public Health, University of Sydney 4 Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Italy 5 Diaverum Corporate Medical-Scientific Office, Lund, Sweden

Correspondence and offprint requests to: Giovanni F. M. Strippoli, Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (Ch), Italy. Tel: +39-3358756828; Fax: +39-0805096087; E-mail: suetoniapalmer@clear.net.nz; strippoli@negrisud.it

Keywords: bone; guidelines; parathyroid hormone; phosphorus; secondary hyperparathyroidism

The first 150 words of the full text of this article appear below.

Since the mid-1990s, many studies showing increased mortality with higher serum calcium [1], phosphorus [2] and parathyroid hormone (PTH) [3] levels in dialysis-dependent patients have been reported. By 2003, the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) released guidelines for mineral metabolism for all stages of chronic kidney disease (CKD) that have been influential in determining practice patterns [4]. For stage 5 CKD (estimated GFR <15 ml/min/1.73 m2), these guidelines prescribed serum targets of 16.5–33 pmol/l (150–300 pg/ml) for PTH, 1.1–1.8 mmol/l (3.5–5.5 mg/dl) for phosphorus and 2.1–2.4 mmol/l (8.4–9.5 mg/dl) for calcium. Target ranges for serum calcium, phosphorus and PTH were developed by K/DOQI based on the available literature of the time and have been both standard practice for clinical care [5,6] and primary outcomes for research [7,8] ever since. While the majority of . . . [Full Text of this Article]


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