Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Dialysis

Is the road to survival paved with good mineral management?

Nature Reviews Nephrology volume 7, pages 185–186 (2011)Cite this article

Subjects

A recent observational study from the UK raises questions over the control of mineral metabolism parameters to within target levels defined by the KDOQI clinical practice guidelines. Data from this study highlight the need for a randomized controlled trial to determine whether optimal management of bone mineral metabolism actually provides any survival benefit.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Block, G. A., Hulbert-Shearon, T. E., Levin, N. W. & Port, F. K. Association of serum phosphorus and calcium × phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am. J. Kidney Dis. 31, 607–617 (1998).

    Article  CAS  Google Scholar 

  2. Kalantar-Zadeh, K. et al. Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients. Kidney Int. 70, 771–780 (2006).

    Article  CAS  Google Scholar 

  3. Wald, R. et al. Disordered mineral metabolism in hemodialysis patients: an analysis of cumulative effects in the Hemodialysis (HEMO) study. Am. J. Kidney Dis. 52, 531–540 (2008).

    Article  CAS  Google Scholar 

  4. Kidney Disease: Improving Global Outcomes (KDIGO) CKD–MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD-MBD). Kidney Int. Suppl. 113, S1–S130 (2009).

  5. Tangri, N. et al. Effect of bone mineral guideline target achievement on mortality in incident dialysis patients: an analysis of the United Kingdom renal registry. Am. J. Kidney Dis. doi:10.1053/j.ajkd.2010.08.037.

    Article  Google Scholar 

  6. Wolf, M. et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 72, 1004–1013 (2007).

    Article  CAS  Google Scholar 

  7. Isakova, T. et al. Phosphorus binders and survival on hemodialysis. J. Am. Soc. Nephrol. 20, 388–396 (2009).

    Article  CAS  Google Scholar 

  8. Danese, M. D., Belozeroff, V., Smirnakis, K. & Rothman, K. J. Consistent control of mineral and bone disorder in incident hemodialysis patients. Clin. J. Am. Soc. Nephrol. 3, 1423–1429 (2008).

    Article  Google Scholar 

  9. Drüeke, T. B. et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N. Engl. J. Med. 355, 2071–2084 (2006).

    Article  Google Scholar 

  10. Appel, L. J. et al. Intensive blood-pressure control in hypertensive chronic kidney disease. N. Engl. J. Med. 363, 918–929 (2010).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, 143 Shimo-Kasuya, 259-1193, Isehara, Japan

    Hirotaka Komaba & Masafumi Fukagawa

Authors
  1. Hirotaka Komaba
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masafumi Fukagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masafumi Fukagawa.

Ethics declarations

Competing interests

H. Komaba declares associations with Chugai Pharmaceutical and Kyowa Hakko Kirin. M. Fukagawa declares associations with Bayer Yakuhin, Chugai Pharmaceutical and Kyowa Hakko Kirin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Komaba, H., Fukagawa, M. Is the road to survival paved with good mineral management?. Nat Rev Nephrol 7, 185–186 (2011). https://doi.org/10.1038/nrneph.2011.25

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2011.25

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing