Kidney Disease: Improving Global Outcomes (KDIGO) recently held a major Controversies Conference on the subject of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD).  The CKD-MBD Controversies Conference, held on October 25-27, 2013, was co-chaired by Mary Leonard, MD of the University of Pennsylvania and Markus Ketteler, MD from the Coburg Clinic, Germany.

The first KDIGO Controversies Conference on Definition, Diagnosis, and Classification of Renal Osteodystrophy was held in Madrid, Spain in 2005.  That conference was regarded as a breakthrough event concerning the understanding of and approach towards mineral and bone disturbances in the context of renal disease.  The term “chronic kidney disease – mineral and bone disorder” (CKD-MBD) was coined at that conference and began to replace the bone-centric concept of “renal osteodystrophy” (ROD) worldwide.  CKD-MBD was defined as a trinity of bone abnormalities, laboratory abnormalities and vascular calcification, linked to hard outcomes such as fractures, cardiovascular morbidity and mortality.  As a result of that conference, the initiative to create a new global guideline on the diagnosis and therapy of CKD-MBD was set in motion, and the KDIGO Clinical Practice Guideline on CKD-MBD was published in 2009.

The question was recently raised as to whether the 2009 guideline requires revision.  During the last few years, a significant body of new evidence has accumulated, with potential impact for CKD-MBD-relevant diagnostic and therapeutic decision-making.  The purpose of the 2013 KDIGO Controversies Conference on CKD-MBD was to determine if it is time for a comprehensive revision of the CKD-MBD guideline and if so, what the scope of these revisions should be.