title: Evaluation of fracture risk in chronic kidney disease.
abstract: Chronic kidney disease (CKD) is associated with mineral and bone disorders (MBD) that are now considered as a syndrome. Bone fragility and a four to tenfold increased rate of skeletal fractures are often reported in CKD patients. The evaluation of the risk of these fractures in CKD patients should explore the same risk factors identified for the general population including low body weight, menopause, personal and familial history of osteoporosis, chronic inflammatory diseases, and corticosteroid therapy. The aim of this article is to provide a critical review of the tools used for the evaluation of bone loss and the risk of fracture in CKD patients, ranging from the measurement of bone mineral density (BMD), fracture risk assessment (Frax™), quantitative computed tomography (QCT), high-resolution peripheral quantitative computed tomography (HRpQTC), to circulating biomarkers of bone metabolism including vitamin D, parathyroid hormone (PTH), bone-specific alkaline phosphatase, osteocalcin, and some collagen type 1-related molecules indicators of bone remodeling.
authors.affiliation: Ramsay-Générale de Santé, Clinique du Landy, Saint-Ouen, France. urena.pablo@wanadoo.fr.|Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris, France. urena.pablo@wanadoo.fr.
authors.forename: Pablo Antonio Ureña
authors.initials: PAU
authors.lastname: Torres
authors.affiliation: INSERM U1132 and USPC Paris-Diderot, Paris, France.|Department of Rheumatology, Hôpital Lariboisière, Paris, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Cohen-Solal
mesh_terms: D015502:Absorptiometry, Photon; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D015675:Osteocalcin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase
keywords: Bone; Bone mineral density; Calcium; PTH; Phosphate; Skeletal fracture; Vitamin D