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W.B. Saunders Philadelphia, PA The Official Journal of the National Kidney Foundation EDITORIAL BOARD American Journal of AJKD Kidney Diseases Editor-in-Chief Bertram L. Kasiske, MD Minneapolis, MN Co-Editors Blanche Chavers, MD Robert Foley, MB Minneapolis, MN Minneapolis, MN Mark Rosenberg, MD Suzanne Swan, MD Minneapolis, MN Minneapolis, MN Education Editor Pathology Editor Stuart Linas, MD Agnes Fogo, MD Denver, CO Nashville, TN Associate Editors George Bakris, MD Donald Hricik, MD Luis Ruilope, MD Chicago, IL Cleveland, OH Madrid, Spain Timothy Bunchman, MD Hi Bahl Lee, MD Nestor Schor, MD Grand Rapids, MI Seoul, Korea Sa˜o Paulo, Brazil Daniel Cattran, MD Adeera Levin, MD Catherine Stehman-Breen, MD Toronto, Canada Vancouver, Canada Seattle, WA Ricardo Correa-Rotter, MD Philip Kam Tao Li, MD Yasuhiko Tomino, MD Mexico City, Mexico Hong Kong, P.R.O.C. Tokyo, Japan Jonathan Craig, MBChB Francesco Locatelli, MD Katherine Tuttle, MD Sydney, Australia Lecco, Italy Spokane, WA Paul de Jong, MD Sharon Moe, MD Yves Vanrenterghem, MD Groningen, The Netherlands Indianapolis, IN Leuven, Belgium A. Meguid El Nahas, MD Emil Paganini, MD Christoph Wanner, MD Sheffield, United Kingdom Cleveland, OH Wu¨ rzburg, Germany Denis Fouque, MD Hamid Rabb, MD David Wheeler, MD Lyon, France Baltimore, MD London, United Kingdom Thomas Golper, MD Nashville, TN Statistical Reviewers David Gilbertson, PhD Jon Snyder, MS Minneapolis, MN Minneapolis, MN Editorial Office Managing Editor Assistant Managing Editor Deanna Gunderson Anna Gillette Minneapolis, MN Minneapolis, MN The Official Journal of the National Kidney Foundation VOL 42, NO 4, SUPPL 3, OCTOBER 2003 CONTENTS American Journal of AJKD Kidney Diseases K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease Tables............................................................................................................................... S1 Figures ............................................................................................................................. S2 Algorithms ....................................................................................................................... S3 Acronyms and Abbreviations........................................................................................ S4 Work Group Membership ............................................................................................... S5 Foreword.......................................................................................................................... S7 Introduction ..................................................................................................................... S10 Guideline Statements ..................................................................................................... S12 Background ..................................................................................................................... S29 Methods for Analysis of Literature................................................................................ S45 Clinical Practice Guidelines Guideline 1. Evaluation of Calcium and Phosphorus Metabolism ............................ S52 Guideline 2. Assessment of Bone Disease Associated With CKD............................... S57 Guideline 3. Evaluation of Serum Phosphorus Levels ............................................... S62 Guideline 4. Restriction of Dietary Phosphorus in Patients With CKD ..................... S63 Guideline 5. Use of Phosphate Binders in CKD ......................................................... S70 Guideline 6. Serum Calcium and Calcium-Phosphorus Product .............................. S77 Guideline 7. Prevention and Treatment of Vitamin D Insufficiency and Vitamin D Deficiency in CKD Patients