Results of a survey on practice patterns at the end of a study involving CKD-MBD management at dialysis facilities: As a part of MBD-5D study

MBD-5D (Mineral and Bone Disorders Outcomes Study for Japanese Chronic Kidney Disease stage 5D patients) is a prospective, multicenter, observational study on hemodialysis patients with secondary hyperparathyroidism (SHPT). Here, we report the results of a “survey on practice patterns” that 79 facilities responded to at the end of a study and compared them with their baseline results in terms of the achievement of “Guidelines for the management of SHPT in dialysis patients” published in 2006, discussing possible impacts on practice patterns and treatment. The percentage of facilities whose target range at the baseline fell within that of the guidelines was 60% with corrected serum calcium, 71.8% with serum phosphorus, and 54.1% with serum iPTH, and 59.5, 73.4, and 57.0%, respectively, at the end of the study. The percentage of facilities that set their upper-limit of the serum phosphorus target range lower than 6.0 mg/mL in the guideline increased from 26.6 to 35.4%. In contrast, the percentage of facilities that set their upper-limit of iPTH higher than the guideline value of 180 pg/mL decreased from 34.2 to 29.1% at the end of the study. Moreover, averaged serum iPTH levels decreased from 328 to 225 pg/mL, and the percentage of patients with iPTH over 180 pg/mL markedly decreased from 82.5 to 47.1% and the achievement of the guidelines significantly increased from 14.7 to 42.2% (p