What are the recommended screening protocols for CKD-MBD in patients with stage 3 or higher chronic kidney disease?

Recommended screening protocols for CKD-MBD in patients with stage 3 or higher CKD:

• Do not routinely measure serum calcium, phosphate, parathyroid hormone (PTH), and vitamin D levels in adults with a GFR of 30 ml/min/1.73 m² or more (CKD stages G1, G2, or G3) ¹.
• Measure serum calcium, phosphate, and parathyroid hormone concentrations in adults with a GFR of less than 30 ml/min/1.73 m² (CKD stages G4 or G5) ¹.
• Determine the frequency of subsequent testing based on the measured values and clinical circumstances; seek specialist opinion if uncertain ¹.
• Do not routinely offer vitamin D supplementation to manage or prevent CKD-MBD, but offer colecalciferol or ergocalciferol to treat vitamin D deficiency in people with CKD and vitamin D deficiency ¹.
• If vitamin D deficiency is corrected and CKD-MBD symptoms persist, offer alfacalcidol or calcitriol to people with GFR less than 30 ml/min/1.73 m² (G4 or G5) and monitor serum calcium and phosphate concentrations during treatment ¹.