Management of mineral and bone disorders in patients on dialysis: a team approach to improving outcomes.

Most patients with mineral and bone disorders do not simultaneously achieve KDOQI target goals for parathyroid hormone, calcium, phosphorus, and the calcium-phosphorus product. A multidisciplinary team composed of the patient, nephrologists, nephrology nurses, renal dietitians, social workers, patient care technicians, clinical pharmacists, and physical therapists can help improve the coordination of care for mineral and bone disorders. The roles of team members are reviewed, with emphasis on nephrology nurses.