Management of bone and mineral metabolism requires an interdisciplinary approach that includes the patient. Often misunderstood, this management involves balancing several clinical indicators and medications. KDOQI recommends that:
- The phosphorus concentration in dialysis patients be maintained between 3.5 and 5.5 mg/dL.
- The optimal range for calcium concentration is 8.4 to 9.2 mg/dL, with an acceptable range being between 8.4 and 10.2 mg/dL.
The Payment Year 2016 Quality Incentive Program includes a hypercalcemia measure. The focus of this measure is on the proportion of 3-month rolling averages of uncorrected serum calcium that are greater than 10.2 mg/dL.