Evidence-Based Guidelines for the Diagnosis and Treatment of Pediatric CKD-Mineral and Bone Disorder (Version 2024)

Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) in children refers to the systemic mineral and bone metabolism disorders caused by CKD, including biochemical abnormalities, abnormalities in bone turnover, mineralization, quality, and ectopic calcification. Like the adult patients, mineral metabolism and bone structure abnormalities are universally present in children with CKD. But there have been no guidelines specifically for the children in the past. The medication treatment and clinical practices for children are usually based on those for adults, lacking targeted guidance. On the one hand, the children are in the process of growth and development, and the adult guidelines do not take into account the characteristics of children. On the other hand, the medication range for children is different from that of adults, and new drugs have been verified and tested in children. Hence, based on the developmental characteristics of children, combined with expert opinions from adults, children, kidney, nutrition, and medicine, this guideline was initiated by the Subspecialty Group of Nephrology, the Society of Pediatrics, Chinese Medical Association. It answered 15 important clinical questions related to the diagnosis and treatment of pediatric CKD-MBD, aimed to provide individualized treatment plans considering the clinical characteristics of CKD children and their treatment goals, while also addressing the needs of their growth and development.