Table 1.

Monitoring recommendations.

Biochemical abnormality	KDIGO (2009) (Chapter 3.1)	KDOQI (2003) (Guideline 1.1)	Author opinion
Phosphorus and calcium	CKD 3: 6–12 months CKD 4: 3 – 6 months CKD 5 – 5D: 1 – 3 months	CKD 3: 12 months CKD 4: 3 months KD 5 – 5D: monthly	Consider demograph- ics, co-morbidities and nutritional status when interpreting results. Do not consider CKD-MBD parameters in isolation. Examine temporal trends to guide treat- ment decisions.
Parathyroid hormone	CKD 3: Based on baseline level and CKD progression CKD 4: 6 – 12 months CKD 5–5D: 3–6 months	CKD 3: 12 months CKD 4: 3 months CKD5-5D: monthly
Alkaline phosphatase	CKD 4 – 5D: every 12 months or more frequently in the pres- ence of elevated PTH	No specific recom- mendation

KDIGO recommend that the frequency of monitoring of serum phosphorus, calcium and PTH be based on the presence and magnitude of abnormalities, and the rate of progression of CKD. 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. KDIGO = kidney disease improving global outcomes; KDOQI = kidney disease outcomes quality initiative; CKD = chronic kidney disease; PTH = parathyroid hormone.