CHRONIC KIDNEY DISEASE KDIGO CKD-MBD guideline update: evolution in the face of uncertainty

Management of mineral and bone disorders in patients with chronic kidney disease (CKD-MBD) requires an understanding of the complex interactions among ions, hormones and their target organs. Since publication of the KDIGO CKD-MBD guideline in 2009, our understanding of disease pathophysiology has improved; however, a paucity of high-quality clinical evidence to support specific interventions remains. Using available data, KDIGO has now updated diagnostic and therapeutic recommendations for patients with CKD-MBD.