Volume 78, Pages S10-S21 (August 2010) Kidney bone disease and mortality in CKD: revisiting the role of vitamin D, calcimimetics, alkaline phosphatase, and minerals  Kamyar Kalantar-Zadeh, Anuja Shah, Uyen Duong, Rulin C. Hechter, Ramanath Dukkipati, Csaba P. Kovesdy  Kidney International  Volume 78, Pages S10-S21 (August 2010) DOI: 10.1038/ki.2010.189 Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 1 Parathyroid hormone (PTH) distribution in 130,525 prevalent Japanese hemodialysis patients in 2007.55 Median dialysis vintage is 4 years. Data are abstracted from the ‘Japanese Society for Dialysis Therapy’ registry of dialysis patients (http://www.jsdt.or.jp), which recommends a PTH target range of 80–120pg/ml.54 KDOQI, Kidney Disease Outcome Quality Initiative. Kidney International 2010 78, S10-S21DOI: (10.1038/ki.2010.189) Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 2 The U-shaped association between serum intact parathyroid hormone (PTH) and survival in 58,058 maintenance hemodialysis patients over 2 years. KDOQI, Kidney Disease Outcome Quality Initiative; MICS, malnutrition–inflammation complex; VDRA, vitamin D receptor activator. (adapted from Kalantar-Zadeh et al.15) Kidney International 2010 78, S10-S21DOI: (10.1038/ki.2010.189) Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 3 Schematic representation of the links between components of kidney bone disease and vascular calcification. Note potential contributors of low parathyroid hormone (PTH) level and its confounded association with poor outcomes. MICS, malnutrition–inflammation complex; VDRA, vitamin D receptor activator. Kidney International 2010 78, S10-S21DOI: (10.1038/ki.2010.189) Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 4 A comparison between survival predictability of serum parathyroid hormone (PTH) (as shown inFigure 2) and serum alkaline phosphatase in dialysis patients. Kidney International 2010 78, S10-S21DOI: (10.1038/ki.2010.189) Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 5 Mean serum alkaline phosphatase according to the tertiles of T score 154 maintenance hemodialysis patients. (adapted from Park et al.80) Kidney International 2010 78, S10-S21DOI: (10.1038/ki.2010.189) Copyright © 2010 International Society of Nephrology Terms and Conditions

Figure 6 Comparing conventional (fixed covariate) survival models vs time-dependent (repeated measure) models in examining the association between serum calcium and survival in chronic kidney disease patients. Kidney International 2010 78, S10-S21DOI: (10.1038/ki.2010.189) Copyright © 2010 International Society of Nephrology Terms and Conditions