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Guidelines for disorders of mineral metabolism and secondary hyperparathyroidism should not yet be modified

Nature Clinical Practice Nephrology volume 2, pages 337–339 (2006)Cite this article

Abstract

This brief article is a response to the article by Monge et al. on page 326 entitled Reappraisal of 2003 NKF-K/DOQI guidelines for management of hyperparathyroidism in chronic kidney disease patients. We contend that there is insufficient evidence to support the changes to clinical practice and clinical practice guidelines proposed by Monge and colleagues. We recommend that clinical trials be conducted to resolve these points of contention and other critical issues in the management of disorders of mineral metabolism in chronic kidney disease, including secondary hyperparathyroidism. The focus should be on evaluating the effects of alternative strategies on survival, as well as clinical manifestations of cardiovascular and bone disease.

Key Points

  • In 2003, the US National Kidney Foundation (NKF) established clinical practice guidelines for the management of disorders of mineral metabolism in chronic kidney disease patients

  • Many of the recommendations in the 2003 NKF-K/DOQI guidelines were based on expert opinion rather than data from high-quality clinical trials

  • On page 326 of this issue, Monge et al. challenge the validity of some of the NKF-K/DOQI recommendations

  • In this article, Ix et al. contend that the revised recommendations proposed by Monge et al. are currently supported by insufficient evidence

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Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, University of California, San Francisco, CA, USA

    Joachim H Ix

  2. The Kidney Institute and Division of Nephrology, and Vice Chairman for Research in the Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA

    L Darryl Quarles

  3. the Division of Nephrology, Department of Medicine, and Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    Glenn M Chertow

Authors
  1. Joachim H Ix
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  2. L Darryl Quarles
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  3. Glenn M Chertow
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Corresponding author

Correspondence to Joachim H Ix.

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Competing interests

Dr Quarles has been a consultant and member of the speaker's bureau for Amgen, Inc.

Dr Chertow has served on advisory boards and has received research support from Genzyme, Inc. and Amgen, Inc.

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Ix, J., Quarles, L. & Chertow, G. Guidelines for disorders of mineral metabolism and secondary hyperparathyroidism should not yet be modified. Nat Rev Nephrol 2, 337–339 (2006). https://doi.org/10.1038/ncpneph0190

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