Management of osteoporosis in CKD Stages 3 to 5.
Osteoporosis and chronic kidney disease (CKD) are both common conditions of older adults and both may be associated with substantial morbidity. However, biochemical and histologic changes that occur with progressive kidney disease require specific interventions, some of which may be concordant with osteoporosis management in the general population, whereas others may be less relevant or perhaps even harmful. In this article, we review the diagnosis of and management strategies for osteoporosis in individuals with CKD, placing these into perspective with the recently published KDIGO (Kidney Disease: Improving Global Outcomes) guidelines for treatment of CKD-mineral and bone disorder (CKD-MBD). Specifically, we highlight osteoporosis treatment recommendations by CKD stage and discuss new avenues for osteoporosis treatment that may be useful in individuals with CKD.
Gordon
Patricia L
PL
University of California San Francisco, San Francisco, CA, USA.
Frassetto
Lynda A
LA
D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000818:Animals; D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002116:Calcitonin / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008019:Life Style; D008279:Magnetic Resonance Imaging; D053580:Muscle Strength / Q000502:physiology; D009277:Nandrolone / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077603:Nandrolone Decanoate; D009569:Nitric Oxide / Q000008:administration & dosage; D010024:Osteoporosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D010281:Parathyroid Hormone / Q000097:blood / Q000502:physiology; D010710:Phosphates / Q000097:blood; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000503:physiopathology; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D019379:Teriparatide / Q000008:administration & dosage / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D010281:Parathyroid Hormone; D010710:Phosphates; D020845:Selective Estrogen Receptor Modulators; D019379:Teriparatide; D009569:Nitric Oxide; D020849:Raloxifene Hydrochloride; D009277:Nandrolone; D002116:Calcitonin; D000077603:Nandrolone Decanoate