Consensus Evidence-Based Clinical Practice Recommendations for the Diagnosis and Treat-To-Target Management of Osteoporosis in Chronic Kidney Disease Stages G4-G5D and Post-transplantation: An Initiative of Egyptian Academy of Bone Health

被引：4

作者：

El Miedany, Yasser ^{[1
]}

Gadallah, Naglaa Ali ^{[2
]}

Sarhan, Eman ^{[3
]}

Toth, Mathias ^{[4
]}

El Naby, Mona Mansour Hasab ^{[2
]}

Elwy, Mohamed ^{[2
]}

Ganeb, Sahar ^{[5
]}

El Gaafary, Maha ^{[6
]}

Mortada, Mohamed ^{[7
]}

Nasef, Samah Ismail ^{[8
]}

Mohannad, Nevine ^{[9
]}

Mahran, Safaa Ali ^{[10
]}

Abu-Zaid, Mohammed Hassan ^{[11
]}

Eissa, Mervat ^{[12
]}

Hassan, Waleed ^{[5
]}

Medhat, Basma M. ^{[12
]}

Ghaleb, Rasha ^{[13
]}

Tabra, Samar Abdelhamed ^{[11
]}

Saber, Heba Gamal ^{[14
]}

Ibrahim, Rehab Ali ^{[2
]}

Saber, Sally ^{[2
]}

Galal, Salwa ^{[2
]}

机构：

[1] Canterbury Christ Church Univ, Rheumatol, Canterbury, Kent, England

[2] Ain Shams Univ, Fac Med, Rheumatol & Rehabil, Cairo, Egypt

[3] Ain Shams Univ, Fac Med, Nephrol, Cairo, Egypt

[4] Darent Vally Hosp, Rheumatol, Dartford, England

[5] Benha Univ, Fac Med, Rheumatol, Banha, Egypt

[6] Ain Shams Univ, Fac Med, Community Med, Cairo, Egypt

[7] Zagazig Univ, Fac Med, Rheumatol, Zagazig, Egypt

[8] Suez Canal Univ, Fac Med, Rheumatol & Rehabil, Ismailia, Egypt

[9] Alexandria Univ, Fac Med, Internal Med & Rheumatol, Alexandria, Egypt

[10] Assiut Univ, Fac Med, Rheumatol & Rehabil, Assiut, Egypt

[11] Tanta Univ, Fac Med, Rheumatol, Tanta, Egypt

[12] Cairo Univ, Fac Med, Rheumatol, Cairo, Egypt

[13] Minia Univ, Fac Med, Rheumatol & Rehabil, Al Minya, Egypt

[14] Ain Shams Univ, Fac Med, Geriatr Med, Cairo, Egypt

来源：

KIDNEY DISEASES | 2022年 / 8卷 / 05期

关键词：

Osteoporosis; DXA; Bone mineral density; Chronic renal insufficiency; Chronic kidney disease-mineral bone disorder; Mineral metabolism; Renal osteodystrophy; FRAX; Denosumab; Parathyroid hormone; Bisphosphonate; Vitamin D; Dialysis; Kidney transplant; MINERAL DENSITY; HEMODIALYSIS-PATIENTS; BIOCHEMICAL MARKERS; RISK-FACTORS; FRACTURES; DIALYSIS; QUALITY; HIP; PREVENTION; PREVALENCE;

D O I：

10.1159/000526492

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: The aim of this study was to reach a consensus on an updated version of the recommendations for the diagnosis and Treat-to-Target management of osteoporosis that is effective and safe for individuals with chronic kidney disease (CKD) G4-G5D/kidney transplant. Methods: Delphi process was implemented (3 rounds) to establish a consensus on 10 clinical domains: (1) study targets, (2) risk factors, (3) diagnosis, (4) case stratification, (5) treatment targets, (6) investigations, (7) medical management, (8) monitoring, (9) management of special groups, (10) fracture liaison service. After each round, statements were retired, modified, or added in view of the experts' suggestions, and the percent agreement was calculated. Statements receiving rates of 7-9 by more than 75% of experts' votes were considered as achieving consensus. Results: The surveys were sent to an expert panel (n = 26), of whom 23 participated in the three rounds (2 were international experts and 21 were national). Most of the participants were rheumatologists (87%), followed by nephrologists (8.7%), and geriatric physicians (4.3%). Eighteen recommendations, categorized into 10 domains, were obtained. Agreement with the recommendations (rank 7-9) ranged from 80 to 100%. Consensus was reached on the wording of all 10 clinical domains identified by the scientific committee. An algorithm for the management of osteoporosis in CKD has been suggested. Conclusion: A panel of international and national experts established a consensus regarding the management of osteoporosis in CKD patients. The developed recommendations provide a comprehensive approach to assessing and managing osteoporosis for all healthcare professionals involved in its management. (C) 2022 The Author(s). Published by S. Karger AG, Basel

引用

页码：392 / 407

页数：16

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