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ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

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Kidney Week

Educational Symposium

Contemporary Issues in CKD-MBD

November 07, 2019 | 12:45 PM - 01:45 PM

Location: Independence Ballroom, Marriott Marquis

Session Description

Phosphorus in the form of adenosine triphosphate (ATP) is literally the energy and source of life. However, phosphorus is also the bane of life, particularly for patients undergoing dialysis. Even though no randomized controlled trials have established the optimal levels of serum phosphorus in patients receiving chronic maintenance hemodialysis, observational studies and experimental models suggest that high serum phosphorus levels are associated with cardiovascular events and mortality. Patient nonadherence to dietary restrictions is often considered the key factor for uncontrolled hyperphosphatemia; the first presentation examines the hidden sources of phosphorus in the diet and provides evidence that patient nonadherence is not always the issue.

KDIGO first issued CKD-MBD guidelines in 2009 and provided a selective update in 2017. Furthermore, the ESRD Quality Improvement Program (QIP) also monitors serum calcium as a quality measure. In this tenth anniversary of the original CKD-MBD guidelines, it’s worth examining the impact of these guidelines and QIP on serum calcium and phosphorus levels and clinical practice in the United States.

Support is provided by an educational grant from Fresenius Medical Care Renal Therapies Group.

Learning Objective(s)

  • Describe the hidden sources of phosphorus in the diet and their impact on serum phosphorus levels in patients receiving chronic maintenance hemodialysis
  • Discuss the real-world impact of guidelines and QIP on measures of CKD-MBD
  • Discuss the impact of these issues on the treatment of CKD-MBD

Learning Pathway(s)

  • Bone and Mineral Metabolism


  • Bryan R. Kestenbaum, MD, MS


  • Introduction
    12:45 PM - 12:55 PM
    Bryan R. Kestenbaum, MD, MS
  • Hidden in Plain Sight: Dietary Sources of Phosphorus
    12:55 PM - 01:15 PM
    Richard A. Sherman, MD
  • MBD Guidelines and Quality Improvement Program: Anything Changed in Clinical Practice?
    01:15 PM - 01:35 PM
    Rajiv Saran, MD, MBBS, MS
  • Questions and Answers
    01:35 PM - 01:45 PM