Abstract
Objective: To identify the gold standard proposal for prevention and treatment for mineral and bone disorders in adults and the elderly with chronic kidney disease non dialysis. Methods: a systematic review of randomized controlled trials. Results: eight articles: calcitriol or cholecalciferol, with calcitriol having a better result in correcting hypocalcaemia, reducing serum alkaline phosphatases and parathyroid hormone; alfacalcidol with bone disease control in 42% of patients; cholecalciferol increased serum calcidiol and decreased serum levels of parathormone; cholecalciferol for a prolonged period with improvement in vitamin D deficiency and decreased serum levels of parathormone; alendronate for a long time did not alter the progression of vascular calcification; calcium acetate, lanthanum carbonate or sevelamer carbonate decreased the average urine phosphorus and attenuated the progression of hyperparathyroidism; calcitriol associated with dietary calcium intervention, isolated calcitriol decreased fasting PTHi levels and, when combined with dietary calcium, normalized the postprandial responses of calcemia and parathyroid and calcium carbonate or sevelamer associated with a phosphorus-restricted diet. The sevelamer showed better results with a significant reduction in mortality from all causes. Final considerations: There was no consensus among the authors as to the gold standard therapy for patients with BMD-CKD in early stages.