Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.


築地 淳 岡山大学大学院環境学研究科 生命環境学専攻 国際保健学分野
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In November 2006, The Japanese Society for Dialysis Therapy (JSDT) announced its first guideline, "The guideline for the management of secondary hyperparathyroidism in chronic dialysis patients," which gives the recommended range of management target values, especially for serum phosphorus, corrected serum calcium and serum intact parathyroid hormone concentrations. Recent studies have suggested that these factors are independently associated with mortality, especially increased cardiovascular mortality. In this research we focused on the serum phosphorus concentration because it is the highest clinical factor among these three. We systematically reviewed almost all documents that discussed the relation between serum phosphorus concentration and mortality as well as the "range of the management target value" specified by foreign guidelines from the US, UK, Canada, Australia and other countries. We summarized the finding concerning the serum phosphorus value of dialysis patients (especially the upper bound value). As a result, it was found that the "range of the management target value" varied among these guidelines. The reasons for this variation likely included differences in the measurement day, in the categories of serum phosphorus concentration, and in the exposure conditions among the studies to which the guidelines referred. Moreover, it was concluded that the Japanese guideline announced by the JSDT should be updated based on the results of future studies.
透析患者 (dialysis patients)
血清リン値 (phosphatemia)
ガイドライン (guideline)
生命予後 (prognosis)