Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) Medication Titration Practices in Hemodialysis Patients in the US

A study examined medication titration practices for treating chronic kidney disease mineral and bone disorder (CKD-MBD) in 23,549 hemodialysis patients in the US from 2006-2015. The medications included vitamin D sterols, phosphorus binders, and calcimimetics. The research found that physicians adjusted medication doses primarily based on CKD-MBD laboratory values, specifically calcium, phosphorus, and parathyroid hormone (PTH) levels, with minimal impact from patient characteristics. Models showed that calcium and phosphorus values from the previous three months influenced decisions to increase or decrease doses. Significant variation was observed between facilities, particularly in vitamin D sterol titration, suggesting opportunities for further clinical trials.