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Opinion : Which of the K/DOQI Guidelines for Bone Disease in Dialysis Patients Should be Changed?
Author(s) -
Shah Nirav,
Piraino Beth
Publication year - 2007
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2007.00236.x
Subject(s) - medicine , vitamin d and neurology , vitamin d deficiency , peritoneal dialysis , kidney disease , hemodialysis , vitamin , dialysis , bone disease , bone remodeling , disease , intensive care medicine , urology , gastroenterology , osteoporosis
The K‐DOQI guidelines for bone metabolism in chronic kidney disease recommend measuring 25(OH) vitamin D levels and correcting deficiencies in stages 3 and 4 but not in ESRD. Most nephrologists are not concerned with 25(OH) vitamin D deficiency, despite evidence in hemodialysis patients that deficient vitamin D status [as measured by 25(OH) vitamin D levels] plays a role in bone disease. PD patients are often deficient in 25(OH) vitamin D in part because of peritoneal effluent losses, and correction may decrease muscle and bone complaints. Data from other populations are indicative of the importance of vitamin D in cancer surveillance and immune functioning. Randomized controlled trials of correction of 25(OH) vitamin D deficiency in both hemodialysis and peritoneal dialysis patients are urgently needed. vitamin D).