title: Osteoporosis management in patient with renal function impairment.
abstract: Aging is associated with decreases in bone quality and in glomerular filtration. Consequently, osteoporosis and chronic kidney disease (CKD) are common comorbid conditions in the elderly, and often coexist. Biochemical abnormalities in the homeostasis of calcium and phosphorus begin early in CKD, leading to an increase in fracture risk and cardiovascular complications since early stages of the disease. The ability of DXA (dual energy X-ray absorptiometry) to diagnose osteoporosis and to predict fractures in this population remains unclear. The management of the disease is also controversial: calcium and vitamin D, although recommended, must be prescribed with caution, considering vascular calcification risk and the development of adynamic bone disease. Furthermore, safety and effectiveness of osteoporosis drugs are not established in patients with CKD. Thus, risks and benefits of antiosteoporosis treatment must be considered individually.
authors.affiliation: Division of Endocrinology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Guilherme Alcantara Cunha
authors.initials: GA
authors.lastname: Lima
authors.affiliation: Division of Endocrinology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Francisco de Paula
authors.initials: Fde P
authors.lastname: Paranhos Neto
authors.affiliation: Division of Nephrology, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil.
authors.forename: Giselly Rosa Modesto
authors.initials: GR
authors.lastname: Pereira
authors.affiliation: Division of Nephrology, UFRJ, Rio de Janeiro, RJ, Brazil.
authors.forename: Carlos Perez
authors.initials: CP
authors.lastname: Gomes
authors.affiliation: Division of Endocrinology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Maria Lucia Fleiuss
authors.initials: ML
authors.lastname: Farias
mesh_terms: D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000150:complications*; D002136:Calcium, Dietary / Q000627:therapeutic use; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000378:metabolism; D050723:Fractures, Bone / Q000209:etiology*; D005919:Glomerular Filtration Rate; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000503:physiopathology; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000378:metabolism
chemical_list: D050071:Bone Density Conservation Agents; D002136:Calcium, Dietary