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Bone and Mineral Metabolism Resource

Welcome to the Nephrology Education in Mineral Metabolism Resource Center

doc_thinking The Education in MINEral Metabolism (EMINEM) project stemmed from a study designed to look at mineral metabolism control in hemodialysis patients across Canada. This project allowed a group of interested Nephrologists to see how well Canadian dialysis centres were reaching the K/DOQI and CSN mineral metabolism targets. As only 17.5 % of patients achieved all the K/DOQI targets and an even smaller proportion, 6.3%, achieved all CSN targets (Hemodialysis International 2010;14:200-210), we decided to develop this EMINEM educational tool.

Using the suggested CSN targets for parathyroid hormone and phosphate as a starting point, we devised a Grid format for classifying individual patients according to their unique mineral metabolism profile. This grid is shown below. The purpose of the Grid was to allow us to present suggested management strategies to move individual patients towards the ideal sector of the Grid.

The EMINEM Resource Centre is more than just the Grid. For example, in the ARTICLES section, our group will present current articles which may impact on our understanding, or on the therapy of Mineral Metabolism derangements. Articles will be critiqued in a scholarly fashion, and comments and discussion around the critiques are welcomed and encouraged. We also hope that you will suggest articles to be reviewed, and present your own reviews for consideration for display on the site.

We would like to encourage DISCUSSION around any aspect of Mineral Metabolism, be it criticisms or comments on the Grid, discussion around the articles reviewed, or any topic of relevance which you would like to see discussed.

Patient Profiles


The tabs above represent three patient groupings Grid

  1. Patients with Low PTH
  2. Patients with Desired PTH
  3. Patients with High PTH


Within each PTH grouping are six boxes, all representing patients with different Calcium and Phosphate parameters. In all there are 18 patient profiles. Click these boxes to learn more about these individual patients.

Explore our working group's recommendations about mineral metabolism management and its complexities. These scenarios are theoretical and are not intended to replace clinical decision making. The suggestions and opinions expressed in these recommendations are based on evidence where it is available, but many of the suggestions represent the opinion of our working group, Canadian Nephrologists with significant interest and some expertise in the field. The purpose of the Grid is not to be prescriptive, but rather suggestive.