[New Developments in CKD-MBD. How to "Thinking Global! Acting Local" for treating CKD-MBD].

"Thinking Global! Acting Local" has been used to express a principle in implementing global guidelines in local. In case of KDIGO 2009 CKD-MBD guideline, Japanese Society of Dialysis Therapy followed the principal part of its global one and published 2012 CKD-MBD guideline for Japanese users. In this guideline, JSDT recommended very different PTH target from the KDIGO and emphasized the parathyroid interventions in their recommendation. Is it a right recommendation as for "Acting Local" ? We should be very careful to implement an opinion-base or low-level evidence-base recommendation to increase a clinical usefulness of guideline.