The KDIGO Controversies Conference on Chronic Kidney Disease–Mineral and Bone Disorder: Progress and Knowledge Gaps Towards Personalizing CKD-MBD Care took place in Madrid, Spain on Thursday, September 28 to Sunday, October 1.

In 2009, KDIGO published a clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD–MBD). In the years following, results from multiple randomized controlled trials and prospective cohort studies provided insights regarding assessment, development, progression, and treatment of CKD-MBD. As a result, in 2013 a KDIGO Controversies Conference on CKD–MBD was convened to address the necessity of revising the 2009 guideline. A total of 12 recommendations were identified for revision, and a selective update of the guidelines was published in 2017. Since then, new lines of evidence have in some cases confirmed and in other cases challenged the existing guidance regarding bone evaluation, diagnosis and inhibition of vascular calcification, prevention of mineralization deficits, targets for vitamin D supplementation, and regulation of parathyroid hormone (PTH).

Picking up on the original organization of the CKD-MBD guideline, this conference involved plenary lectures covering the key literature published since the 2017 guideline update, and new emerging topics of interest were presented with select controversial issues covered more in-depth in the breakout group sessions. Drs. Markus Ketteler (Robert-Bosch-Krankenhaus, Stuttgart, Germany;) and Rosa Maria Affonso Moysés (University of São Paulo, Brazil) co-chaired this conference. The conference output will include publication of a position statement that will help guide KDIGO and the nephrology community on the therapeutic management and future research in CKD-MBD.