{"doi":"10.1007/s11914-025-00911-8","title":"Chronic Kidney Disease-Mineral and Bone Disorder Management in 4D: The Case for Dynamic Treatment Regime Methods to Optimize Care","abstract":"PURPOSE OF REVIEW: Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a complex condition impacting patients with kidney failure and characterized by inter-related features such as hyperparathyroidism, hyperphosphatemia, and hypocalcemia. Current treatments include active vitamin D sterols, calcimimetics, and phosphate binders alone and in combination. However, identifying optimal treatment is challenged by interdependency among CKD-MBD features, requiring new approaches to understand dynamic systems. In this review, we discuss challenges and opportunities for a more integrated view of CKD-MBD care. RECENT FINDINGS: Few clinical studies in CKD-MBD care have incorporated a dynamic understanding of the disorder and its treatment. Dynamic treatment regime methods are an evolving area of artificial intelligence (AI) that offer a promising approach for modeling and understanding CKD-MBD care. Efforts to date have included dynamic systems and quantitative systems pharmacology-based models to simulate the impact of alternative treatment regimes. Additional studies utilizing dynamic treatment regime approaches may help improve knowledge gaps in CKD-MBD care. Although preliminary research highlights the potential of dynamic treatment regime approaches in optimizing CKD-MBD management, further investigation and clinical validation are necessary to fully harness this approach for improving patient outcomes.","journal":"Current Osteoporosis Reports","year":2025,"id":532147,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.967,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1413347,"name":"Adam P. Tashman","orcid":null,"position":1,"is_corresponding":false},{"id":281085,"name":"Julia J. Scialla","orcid":"0000-0003-1707-691X","position":2,"is_corresponding":false},{"id":1412893,"name":"Elizabeth Thompson","orcid":"0009-0009-9254-2010","position":0,"is_corresponding":true}],"reference_count":69,"raw_metadata":null,"created_at":"2026-07-19T02:51:18.928280Z","pmid":"40131582","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}