Diagnosis and Management of Osteoporosis in Advanced Kidney Disease: A Review.
Am J Kidney Dis
; 79(3): 427-436, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-34419519
ABSTRACT
Osteoporosis and fractures are common in persons with advanced chronic kidney disease (CKD) and on maintenance dialysis. Although the diagnosis of osteoporosis in this population can be difficult, imaging, especially with dual-energy x-ray absorptiometry (DXA), is helpful in identifying persons with CKD at the highest risk of fracture. Although blood biomarkers including parathyroid hormone and bone-specific alkaline phosphatase concentrations can aid in assessing bone turnover state, bone biopsy remains the gold standard in determining bone turnover in persons with advanced kidney disease and osteoporosis. With the increasing armamentarium of osteoporosis drugs, it now may be possible to prevent many fractures in advanced CKD. Unfortunately, data on these drugs are limited in persons with advanced CKD. Clinicians, aided by advances in imaging, biomarkers, and bone biopsy can now use these novel agents to target bone turnover abnormalities such as adynamic bone disease and high bone turnover disease. This review will discuss the most recent literature surrounding the diagnosis, management, and monitoring of osteoporosis and fractures in persons with advanced CKD or on maintenance dialysis.
Palavras-chave
Abaloparatide; antiresorptive medications; bone biopsy; bone mineral density (BMD); bone turnover marker (BTM); calcimimetics; chronic kidney diseasemineral and bone disorder (CKD-MBD); dialysis; end-stage renal disease (ESRD); fragility fractures; imaging; osteoporosis; review; teriparatide; vitamin D receptor agonists
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Osteoporose
/
Insuficiência Renal Crônica
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Am J Kidney Dis
Ano de publicação:
2022
Tipo de documento:
Article