Bone mass measurements in men and women with chronic kidney disease.
OBJECTIVE
Fractures are common in patients with chronic kidney disease (CKD) and are associated with substantial morbidity and mortality. Bone mass measurements are commonly used to assess fracture risk in the general population, but the utility of these measurements in patients with CKD is unclear.


RESULTS
This review will outline the epidemiology and etiology of fractures in patients with CKD. Also, we will summarize the published data that describe the association between bone mass measurements and fracture in patients with CKD.


CONCLUSIONS
Patients with CKD suffer from fractures due to impairments in bone quantity, bone quality, and abnormalities of neuromuscular function. The complex etiology of fractures combined with the technical limitations of bone mineral density testing, both by dual energy X-ray absorptiometry and by peripheral quantitative computed tomography, limits the clinical utility of bone mass measurements for fracture prediction in CKD; this is particularly true among patients with stages 4 and 5 CKD. As such, clinicians should not routinely order bone mineral density testing in patients with CKD. Further research, to determine whether bone mineral density together with other noninvasive measures to assess bone strength can predict fracture, is needed.
Jamal
Sophie A
SA
Women's College Hospital, University of Toronto, Toronto, Ontario, Canada. sophie.jamal@utoronto.ca
D015502:Absorptiometry, Photon; D000818:Animals; D015519:Bone Density; D001842:Bone and Bones / Q000033:anatomy & histology*; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D012307:Risk Factors