The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Work Group published the updated clinical practice guidelines online in the Annals of Internal Medicine. The updated recommendations for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD) emphasize that treatment decisions should be based on trends in laboratory values rather than a single abnormal result. Inclusion of evidence published since 2009 supported the revision of 15 recommendations. The guidelines are valuable not only for nephrologists but also for primary care physicians (PCPs), who care for most patients with CKD. A bone biopsy is no longer recommended prior to introducing antiresorptive therapy in patients with CKD stage G4 to G5D. The work group suggests that treatment decisions should be based on serial assessments of phosphate, calcium, and PTH levels and all values should be considered together, and not as stand-alone single values.