Affiliations 

  • 1 Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China
  • 2 Department of Medicine, Showa University School of Medicine, Tokyo, Japan
  • 3 Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 4 Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, Osaka, Japan
  • 5 Department of Renal Medicine, Tan Tock Seng Hospital, Singapore
  • 6 Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
  • 7 Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • 8 Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
  • 9 Renal Division, Department of Medicine, Peking University First Hospital, China
  • 10 Department of Medicine and Geriatrics, Jockey Club Nephrology and Urology Centre, Princess Margaret Hospital, Kowloon, Hong Kong SAR, China
  • 11 Department of Medicine, University of California Irvine Medical Center, Orange, California, USA
  • 12 Nephrology Center, Toranomon Hospital, Kawasaki, Kanagawa, Japan
  • 13 Department of Renal Medicine, Singapore General Hospital, Singapore
  • 14 Department of Nephrology, Serdang Hospital, Jalan Puchong, Kajang, Selangor, Malaysia
  • 15 Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
  • 16 Department of Internal Medicine, Korea University College of Medicine, Guro Hospital, Seoul, South Korea
  • 17 Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • 18 Department of Nephrology, Peking University People's Hospital, Beijing, China
  • 19 Department of Renal Medicine, University College London, London, UK
  • 20 Department of Nephrology, Itabashi Chuo Medical Center, Tokyo, Japan
  • 21 Division of Nephrology, Endocrinology, and Metabolism, Tokai University School of Medicine, Isehara, Japan
Kidney Int Rep, 2019 Nov;4(11):1523-1537.
PMID: 31890994 DOI: 10.1016/j.ekir.2019.09.007

Abstract

Improving Global Outcomes (KDIGO) Clinical Practice Guideline on Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) 2009 provided recommendations on the detection, evaluation, and treatment of CKD-MBD in patients CKD who are and are not undergoing dialysis. Because of the accumulation of evidence since this initial publication, the CKD-MBD Guideline underwent a selective update in 2017. In April 2018, KDIGO convened a CKD-MBD Guideline Implementation Summit in Japan with the key objective to discuss various barriers to the uptake and implementation of the CKD-MBD Guideline in 8 Asian countries/regions. These countries/regions were comparable according to their high-to-middle economic ranking assigned by the World Bank. The discussion took into account the availability of CKD-MBD medication therapies and government health policies that may influence reimbursement and practice patterns in the region. Most importantly, Summit participants developed a framework of multifaceted strategies aimed at overcoming barriers to guideline implementation. The Summit attendees suggested a shared decision-making approach between clinicians and patients in CKD-MBD management, as well as individualized care based on the treatment risk-benefit ratio. The Summit participants also discussed how KDIGO, as a guideline development organization, may work in partnership with local and national nephrology societies to provide education and facilitate implementation of the guideline by clinicians. The conclusions drawn from this Summit in Asia may serve as an important guide for other regions to follow.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.