CKD에서 혈청 phosphate, calcium, iPTH, 25-hydroxyvitamin D 수치 모니터링

CKD에서 혈청 phosphate, calcium, iPTH, 25-hydroxyvitamin D 수치 모니터링

eGFR < 60 mL / min / 1.73 m² 인 환자에서 혈청 phosphate, calcium, iPTH, 25-hydroxyvitamin D 수치를 정기적으로 모니터링합니다. 이 측정의 빈도는 eGFR과 기저 질환 유무, 치료 방법에 따라 다릅니다. 또한, eGFR이 급격히 감소하는 경우 모니터링을 더 자주 시행합니다. 다음 모니터링 스케쥴이 합리적이며 이것은  2017 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines에 근거합니다.

내용 참고   보라색 : KDIGO 2017

                 녹색 : UpToDate 2018.06.30

In CKD G3a–G3b: 
   for serum calcium and phosphate, every 6–12 months
   for PTH, based on baseline level and CKD progression
         at least every 12 months and every 6 months if the baseline concentration is elevated 
         or if the patient is being treated. 
   for 25-hydroxyvitamin D every 12 months and every 6 months if the patient is being treated.
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In CKD G4: 
   for serum calcium and phosphate, every 3–6 months
   for PTH, every 6–12 months
         every 6 months if the baseline concentration is elevated or if the patient is being treated.
   for 25-hydroxyvitamin D every 12 months and every 6 months if the patient is being treated.
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In CKD G5, including G5D: 
   for serum calcium and phosphate, every 1–3 months
   for PTH, every 3–6 months
        every three months if the baseline concentration is elevated or if the patient is being treated.
    for 25-hydroxyvitamin D every 12 months and every 6 months if the patient is being treated.
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In CKD G4–G5D
   for alkaline phosphatase activity, every 12 months, or more frequently in the presence of elevated PTH.

In CKD patients receiving treatments for CKD-MBD, or in whom biochemical abnormalities are identified, it is reasonable to increase the frequency of measurements to monitor for trends and treatment efficacy and side effects (Not Graded).