Bone and Kidney Disease: Diagnostic and Therapeutic Implications

被引：0
作者：
Sophie A. Jamal
Sarah L. West
Paul D. Miller
机构：
[1] University of Toronto,
[2] Women’s College Hospital,undefined
[3] University of Colorado Health Sciences Center,undefined
[4] Colorado Center for Bone Research,undefined
来源：
Current Rheumatology Reports | 2012年 / 14卷
关键词：
Chronic kidney disease; Bone disease; Fractures; Diagnostic; Therapeutic; Bone mineral density; Treatment; Osteoporosis;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Fractures are common in patients with chronic kidney disease (CKD), but the diagnosis and treatment of bone disease in CKD are difficult due to the multiple etiologies of bone disease in these patients. Noninvasive imaging, including bone mineral density by dual energy x-ray absorptiometry, can be useful in diagnosing osteoporosis in predialysis CKD; however, consensus on the diagnosis of osteoporosis among those with advanced CKD—particularly stage 5 CKD patients on dialysis—is lacking. Treatments approved for osteoporosis in postmenopausal women may be used in patients with stage 1 to 3 CKD. Furthermore, post-hoc analyses show efficacy and safety of oral bisphosphonates, raloxifene, and denosumab in stage 4 CKD for short-term treatment. However, treatment decisions are more difficult in stage 5 CKD. Bone biopsy may be required, and most treatments, if used, would be off label. Overall, the diagnosis and treatment of bone disease in patients with CKD require further research.
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页码：217 / 223
页数：6
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  • [1] Ensrud KE(2007)Renal function and risk of hip and vertebral fractures in older women Arch Intern Med 167 133-9
  • [2] Lui LY(2010)Kidney function and rate of bone loss at the hip and spine: the Canadian Multicentre Osteoporosis Study Am J Kidney Dis 55 291-9
  • [3] Taylor BC(2009)Diagnosis and treatment of osteoporosis in chronic renal disease Semin Nephrol 29 144-55
  • [4] Jamal SA(2009)KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD) Kidney Int 76 s1-130
  • [5] Swan VJ(2011)Effects of denosumab on fracture and bone mineral density by level of kidney function J Bone Miner Res 26 1829-35
  • [6] Brown JP(2007)Teriparatide in postmenopausal women with osteoporosis and mild or moderate renal impairment Osteoporos Int 18 59-68
  • [7] Miller PD(2005)Safety and efficacy of risedronate in patients with age-related reduced renal function as estimated by the Cockcroft and Gault method: a pooled analysis of nine clinical trials J Bone Miner Res 20 2105-15
  • [8] Jamal SA(2008)The effect of raloxifene treatment in postmenopausal women with CKD J Am Soc Nephrol 19 1430-8
  • [9] Ljunggren O(2010)Bone mass and microarchitecture in CKD patients with fracture J Am Soc Nephrol 21 1371-80
  • [10] Stehman-Breen C(2011)Discriminants of prevalent fractures in chronic kidney disease J Am Soc Nephrol 22 1560-72
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