Chronic kidney disease–mineral and bone disorder: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
Markus Ketteler; Pieter Evenepoel; Rachel M. Holden; Tamara Isakova; Hanne Skou Jørgensen; Hirotaka Komaba; Thomas L. Nickolas; Smeeta Sinha; Marc Vervloet; Michael Cheung; Jennifer King; Morgan E. Grams; Michel Jadoul; Rosa Maria Affonso Moysés; Carlo Alfieri; Gloria Ashuntantang; Sunita Bavanandan; Antonio Bellasi; Jordi Bover; Rodrigo Bueno de Oliveira; David A. Bushinsky; Iain Bressendorff; Maria Eugênia Fernandes Canziani; Aluizio Barbosa Carvalho; Etienne Cavalier; Daniel Cejka; Wei Chen; Val David; Martin H. de Borst; Michelle Denburg; Grahame J. Elder; Rosilene M. Elias; Jürgen Floege; Masafumi Fukagawa; Maria Fusaro; Daniel Gallego; Charles Ginsberg; Bak-Leong Goh; Rafael Alberto Gomez Acevedo; Orlando M. Gutierrez; Takayuki Hamano; Ditte Hansen; Mathias Haarhaus; Sharon A. Huish; Joachim H. Ix; Meg Jardine; Pascale Khairallah; Young joo Kwon; Marie-Hélène Lafage-Proust; Holly Loughton; Fabrice Mac-Way; Sandro Mazzaferro; Armando Luis Negri; Sagar U. Nigwekar; Irene L. Noronha; Susan M. Ott; Farzana Perwad; Isidro B. Salusky; Julia J. Scialla; Paweena Susantitaphong; Irma Tchokhonelidze; Chikako Terano; Marcello Tonelli; Yusuke Tsukamoto; Michael Walsh; Angela Yee-Moon Wang; Katherine Wesseling-Perry; Myles Wolf; Jiunn Wong
This KDIGO Controversies Conference report synthesises current evidence and expert opinion on the management of CKD-mineral and bone disorder, addressing unresolved clinical questions around biochemical targets, therapeutic interventions, and monitoring strategies. The document likely updates or refines prior KDIGO guidance by identifying where evidence remains insufficient or contested, and where clinical practice varies internationally. It represents a high-level consensus process involving a large, globally representative panel of nephrologists and clinical researchers.
UK applicability
The conclusions of this international KDIGO conference are directly applicable to UK nephrology practice, as KDIGO guidelines are widely adopted within NHS renal services and inform NICE and UK Kidney Association guidance on CKD-MBD management.
Key measures
Serum phosphate, calcium, parathyroid hormone (PTH), fibroblast growth factor-23 (FGF-23), vitamin D metabolites, bone mineral density, vascular calcification scores, and clinical outcomes including fracture and cardiovascular events
Outcomes reported
The conference report summarises areas of consensus and ongoing controversy regarding the diagnosis, monitoring, and treatment of CKD-mineral and bone disorder (CKD-MBD), including disturbances in calcium, phosphate, parathyroid hormone, and vitamin D metabolism, as well as vascular calcification and renal osteodystrophy.
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