CKD-MBD
Newsletter #8 (2), 2017
July 2017
News

As of June 2017 the number of members of our WG is stable at 393.

Activities of the WG during the 54th ERA-EDTA Congress in Madrid have been the following:

1. CME course Implementation of the KDIGO update on CKD-MBD (attended by 328 people):
  Part I
  Chairs: Pieter Evenepoel, Leuven, Belgium and Ziad Massy, Paris, France
  - Should the presence of vascular calcification influence choice of phosphate binder? Jordi Bover, Barcelona, Spain
  - Phosphate binder therapy in predialysis? When and how? Adrian Covic, Iasi, Romania
  - Current insights into dietary intervention to modulate phosphate concentration and balance Vincent Brandenburg, Aachen, Germany
  Part II
  Chairs: David Goldsmith, London, United Kingdom Marc Vervloet, Amsterdam, The Netherlands
  - Screening for fracture risk in CKD Pablo Antonio Ureña Torres, Saint-Ouen, France
  - Position in CKD of novel compounds to treat bone disease Sandro Mazzaferro, Rome, Italy
  - Any position left for active vitamin D? Mario Cozzolino, Milan, Italy
  Invited Lecture: Update on CKD-MBD in Pediatrics Rukshana Shroff, London, United Kingdom
2. Joint Meeting of the CKD-MBD Board with the Japanese Society of Nephrology’s Delegation. Opened by the Presidents of the ERA-EDTA (Prof. Wiecek) and of the Japanese Society of Nephrology (Prof. Kashihara), this meeting testifies the progress of our collaboration with the JSN. Four young researchers, 2 from Europe and 2 from Japan, presented their original researches which were opened to discussion. The titles:
  - Yosuke Nakagawa (Tokai University): Relationship between Sclerostin, Bone metabolism Markers, and Fracture in Hemodialysis Patients: Tokai Dialysis Cohort
  - Dimitri Siriopol (Iasi University, Romania): Association between MBD phenotypes and Mortality Risk: An EuroDOPPS analysis
  - Tatsufumi Oka (Osaka University) : Proteinuria as A Risk Factor of Hypomagnesemia: The Most Common Electrolyte Abnormality in Patients with Chronic Kidney Disease
  - Marc Vila Cuenca (Amsterdam, The Netherlands and Barcelona, Spain): Active vitamin D protects endothelial barrier disruption by CKD
  - Brain storming on collaborative projects and activities on CKD-MBD
3. Calciphylaxis Registry: A Board Meeting was organized to adjourn on the number of Countries actively contributing to the registry. The critical points, mostly on the local EC rules, were discussed. Netherlands and Belgium could announce their progress, which is now expected to start case recordings. A first balance of recruitments is scheduled by the end of the year. 
4. EUROD Board Meeting. This was the first meeting of the board members that are not only nephrologists but also pathologists and endocrinologists. The EUROD initiative aims at revitalizing the bone biopsy policy in renal patients in Europe. Pieter Evenepoel, the promoter, detailed the attendees on the purpose and methods of this new project of the WG. Both incident and prevalent cases will be eligible for inclusion in a registry that is expected to increase our knowledge of bone disease in CKD. Contacts are underway with Companies possibly interested with the project for fund raising.   

Current and upcoming activities
Publications:
1. The second paper in cooperation with the ERA-EDTA working group on Renal Nutrition (ERN) on Vitamin D Status and its Relationship to Muscle Health and Frailty in Chronic Kidney Disease, has been published. Authored by Dr. Pablo Molina, is available on the web (Molina P, Carrero JJ, Bover J, Chauveau P, Mazzaferro S, Torres PU; European Renal Nutrition (ERN) and Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Working Groups of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA) Vitamin D, a modulator of musculoskeletal health in chronic kidney disease. J Cachexia Sarcopenia Muscle. 2017 Jul 3. doi: 10.1002/jcsm.12218. [Epub ahead of print] Review. PMID: 28675610
2. Based on the results of a questionnaire on the subject among European nephrologists, the paper by Pieter Evenepoel on clinical practice in Europe related to bone biopsy policies in CKD, , has been published on NDT (Evenepoel P, D'Haese P, Bacchetta J, Cannata-Andia J, Ferreira A, Haarhaus M, Mazzaferro S, Lafage Proust MH, Salam S, Spasovski G, Cozzolino M; ERA-EDTA Working Group on CKD-MBD. Bone biopsy practice patterns across Europe: the European renal osteodystrophy initiative-a position paper. Nephrol Dial Transplant. 2017 Mar 3. doi: 10.1093/ndt/gfw468. [Epub ahead of print] PMID: 28339949).
3. The CKD-MBD working group intends to critically review the recently published update in the KDIGO guideline on CKD-MBD. If needed, the working group will take initiative to comment on this update, and share its position in a commentary.
Cooperation: The CKD-MBD working group is cooperating with:
- The European Society of Pediatric Nephrology in order to develop common specific lines of clinical research in the field of CKD-MBD, spanning both pediatric and adult nephrology. Two papers have been recently published in collaboration:
1. Rukshana Shroff  Mandy Wan  Evi V. Nagler  Sevcan Bakkaloğlu  Mario Cozzolino Justine Bacchetta  Alberto Edefonti  Constantinos J. Stefanidis  Johan Vande Walle Gema Ariceta  Günter Klaus  Dieter Haffner  Claus Peter Schmitt on behalf of the European Society for Paediatric Nephrology Chronic Kidney Disease Mineral and Bone Disorders and Dialysis Working Groups.  Clinical practice recommendations for treatment with active vitamin D analogues in children with chronic kidney disease Stages 2–5 and on dialysis. Nephrol Dial Transplant (2017) 32 (7): 1114-1127 (https://doi.org/10.1093/ndt/gfx080).
2. Rukshana Shroff  Mandy Wan  Evi V. Nagler  Sevcan Bakkaloğlu  Dagmar-C. Fischer Nicholas Bishop  Mario Cozzolino  Justine Bacchetta  Alberto Edefonti Constantinos J. Stefanidis  Johan Vande Walle  Dieter Haffner  Günter Klaus Claus Peter Schmitt on behalf of the European Society for Paediatric Nephrology Chronic Kidney Disease Mineral and Bone Disorders and Dialysis Working Groups. Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease Stages 2–5 and on dialysis. Nephrol Dial Transplant (2017) 32 (7): 1098-1113. (https://doi.org/10.1093/ndt/gfx065)

- The Japanese Society of Nephrology, (JSN) by being represented at each other meetings, share continental experience and share education. In addition, the working group will offer all support to the JSN if needed in its intention to establish their own MBD group, and is looking forward to intensify cooperation and to bundle forces.
- The European Renal Nutrition (ERN) working group in combining expertise on scientific topics at the boundaries of MBD and the nutritional impact on that.

WG Activities:
A
Calciphylaxis registry. The Internet site (http://www.calciphylaxis.net/) is now available in several languages for local uses.  Italy, Netherlands and Belgium can now recruit patients.
B EUROD. the European Renal OsteoDystrophy network is now well defined. Besides board members meetings a CME Congress will hopefully be organized in 2018. Also, during 2018 the active collection of bone samples is expected to start.
C MBD contribution to clinical endpoints in CKD. Dr. Vervloet and Massy are guiding an ongoing evaluation on data from the large EuroDOPPS registry to identify MBD phenotypes with the highest risk for clinically relevant endpoints.
Scheduled activities
A
The next CME initiative of the group, is entitled “The Parathyroid Hormone (PTH) Day in Chronic Kidney Disease. From Bench to Bedside. Organized by Ziad MASSY, Martine Cohen-Solal, and Pablo Urena, is scheduled in Paris, September 8th, 2017 at the Hotel Pullman Paris Eiffel Tower, 18 avenue de Suffren – Paris. Importantly, in this CME also the best original contributions from young European investigators will be presented orally. The Final Program is the following:
 

09.00-09.15 Introduction: Ziad MASSY, Martine COHEN-SOLAL and Pablo URENA-TORRES
09.15-11.00 Session 1
Lessons from basic science, Parathyroid glands, molecules, and receptors, FGF23/Klotho
Moderators: Jordi BOVER (Spain) and Marc VERVLOET (The Netherlands)
09.15-09.40 1- Parathyroid glands in CKD: anatomy, histology, physiology and molecular biology
in CKD (monoclonality): (Tilman DRUEKE, France)
09.40-10.05 2- Parathyroid glands localization in CKD: Ultrasounds, Scintigraphies, MRI, PET
(Elif HINDIE, France)
10.05-10.30 3- Calcium-sensing and PTH receptor in CKD (Ziad MASSY, France)
10.30-10.55 4- PTH regulation by the Klotho/FGF23 axis in CKD (Mario COZZOLINO, Italy)
BREAK
11.15-12.55 Session 2
Diagnostic issues and PTH as a prognostic biomarker
Moderators: Martine COHEN-SOLAL (France) and Dominique PRIE (France
)
11.15-11.40 5- Effect of PTH, PTHrP and their fragments in the central nervous system (Franck OURY, France)
11.40-12.05 6- PTH measurement in CKD subjects (Etienne CAVALIER, Belgium)
12.05-12.30 7- Relation between PTH and biochemical markers of MBD (Junichiro James KAZAMA, Japan)
12.30-12.55 8- Deleterious effects of PTH on the heart (Vincent BRANDENBURG, Germany)
12.55-14.00 LUNCH
14.00-15.40 Session 3
How to treat secondary hyperparathyroidism anno 2017
Moderators: David GOLDSMITH (UK) and Sandro MAZZAFERRO (Italy)

14.00-14.25 9- Control of secondary hyperparathyroidism by old and new vitamin D compounds
(Stuart SPRAGUE, USA)
14.25-14.50 10- Old and new calcimimetics (João FRAZAO, Portugal)
14.50-15.15 11- Is there any indication for parathyroidectomy in 2017 (Adrian COVIC, Romania)
15.15-15.40 12- Persistent high PTH after kidney transplantation (Pieter EVENEPOEL, Belgium)
BREAK
16.00-16.30 Session 4
Presentation of The Three Best Posters
Moderators: Pablo URENA-TORRES (France) and Ziad MASSY (France)

16.00-16.10: Poster 1 16.10-16.20 Poster 2 16.20-16.30 Poster 3
16.30-17.30 Session 5
Back to practice: clinical cases: what would you do?
Moderators: Pieter EVENEPOEL (Belgium) + all faculty members

16.30-17.00: 13- A clinical case of high PTH (Marc VERVLOET, The Netherlands)
17.00-17.30: 14- A clinical case of low PTH (Sandro MAZZAFERRO, Italy)
17.30-17.45 Conclusions and perspectives (Ziad MASSY and Pablo URENA)

  Travel Grant opportunities available for young investigators.

For more information ask: ckd-mbd@era-edta.org
CKD-MBD related publications in NDT and CKJ
http://www.era-edta.org/ckdmbd/NEWSLETTER_8_2.pdf
As a contribution of ERA-EDTA communication team, we are again reporting on the most recent papers published on the journals of our society and dealing with CKD-MBD. The content of this group of papers is reported in a separate link
Clinical Kidney Journal (CKJ)
The possibility of submitting papers to CKJ free of charge submission fees,
continues up to the end of the year! Run to submit original papers!