[Parathyroid and bone. Management of parathyroid function and evaluation of bone metabolism in hemodialysis patients].

Disturbances in mineral and bone metabolism due to loss of kidney function greatly influence morbidity and quality of life, so Kidney Disease: Improving Global Outcomes (KDIGO) proposed the concept of chronic kidney disease-mineral and bone disorder (CKD-MBD). Japanese Society for Dialysis Therapy has created guidelines for the management of secondary hyperparathyroidism associated prognosis in hemodialysis patients, and we are managing parathyroid function of hemodialysis patients under this guideline. Bone biopsy is not recommended as part of routine evaluation for CKD-MBD because bone biopsy is the invasive examination. KDIGO proposed new histological classification of renal osteodystrophy, TMV classification, for standardizing a result of bone histomorphometry. We expect that new guideline improve the prognosis of hemodialysis patients.