title: [Bone protection in corticosteroid treated patients].
abstract: The Piedmont Group of Clinical Nephrology compared the activity of 15 nephrology centers in Piedmont and Aosta Valley as regards bone protection in patients on corticosteroids therapy. Fracture prevalence shows great variability: in 4/15 centers (27%) no fractures were found, in 6/15 centers (40%) fractures were present in 1-4% of cases, in 1 center in 18% of patients. Clinical risk of fracture was based on sex, age and postmenopausal status in 11/14 of the centers (79%), history of fractures and bone disease in 4/14 centers (27%), smoking and alcohol consumption in 3 and 2 centers respectively, glucocorticoid dose and duration in 4, in children bone age and calcium phosphorus status. Dual energy X-ray absorptiometry was performed in 12 centers based on risk factors, in 8 (57%) DXA was performed during the follow-up, in 4 it was performed after 12 months and in 2 after 2-3 years. DXA is not prescribed in children. Only in one center, risk assessment is based on FRAX. Most of the patients are treated with vitamin D supplementation at a dose of steroids of 5 mg/d (80%). Calcium carbonate is used in 9 centers (60%), in two it is used only in the presence of low ionized calcium or bone mineral density. Bisphosphonates are used following AIFA prescription, in particular alendronate in all centers, risedronate in seven and denosumab in one. The analysis shows the great variability of the clinical and therapeutic approach regarding bone protection in patients on corticosteroids therapy, in Piedmont and Aosta Valley.
authors.forename: Silvana
authors.initials: S
authors.lastname: Savoldi
authors.forename: Franca
authors.initials: F
authors.lastname: Giacchino
authors.forename: Cristiana
authors.initials: C
authors.lastname: Rollino
authors.forename: Marco
authors.initials: M
authors.lastname: Manganaro
authors.forename: Luca
authors.initials: L
authors.lastname: Besso
authors.forename: Cristina
authors.initials: C
authors.lastname: Izzo
authors.forename: Bruno
authors.initials: B
authors.lastname: Gianoglio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Amore
authors.forename: Roberta
authors.initials: R
authors.lastname: Fenoglio
authors.forename: Piero
authors.initials: P
authors.lastname: Stratta
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D050723:Fractures, Bone / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones