Abstract:

K/DOQI guidelines and KDIGO guidelines have offered the recommended target value of intact parathyroid hormone (iPTH) in patients suffering from chronic kidney disease (CKD). These guidelines were based on the conclusions of some observational studies. Few randomized controlled trials (RCT) have shown that the treatment of CKD patients could lead to improved outcomes with iPTH reaching a certain level. Nor have interventional RCT trials been carried out to determine the direct causaleffect relationship between iPTH level and clinical events. The fact that most beneficial iPTH target value varied between various studies indicated that suitable iPTH levels still remains to be determined yet. In this commentary, several domestic and international guidelines concerning the most beneficial iPTH target value have been reviewed. The compliance rate of iPTH target value is low in accordance with K/DOQI guidelines. The evidence of K/DOQI guidelines for setting the iPTH target value is insufficient.The detection method of iPTH is not yet unified. There is no apparent direct relationship between increased iPTH level and increased mortality. So the iPTH target value needs a re-evaluation for the above five existing aspects.

Key words: Intact parathyroid hormone target value, Mortality, K/DOQI guidelines