医学
肾脏疾病
骨重建
骨质疏松症
骨矿物
骨病
内科学
慢性肾脏病矿物质与骨骼疾病
重症监护医学
肾性骨营养不良
作者
Susan M. Ott,Hartmut H. Malluche,Vanda Jorgetti,Grahame J. Elder
标识
DOI:10.1016/j.kint.2021.05.024
摘要
Patients with chronic kidney disease–mineral and bone disorder (CKD-MBD) frequently have low bone formation rates. A recent review suggested that adynamic bone disease is not always associated with negative outcomes and therefore antiresorptive medications could be used more often. However, there is currently no evidence to support an improvement in fracture risk or mortality in patients with CKD-MBD and low bone turnover who are treated with antiresorptive medication. There is reasonable pathophysiological evidence suggesting that it may even be harmful. Patients with chronic kidney disease–mineral and bone disorder (CKD-MBD) frequently have low bone formation rates. A recent review suggested that adynamic bone disease is not always associated with negative outcomes and therefore antiresorptive medications could be used more often. However, there is currently no evidence to support an improvement in fracture risk or mortality in patients with CKD-MBD and low bone turnover who are treated with antiresorptive medication. There is reasonable pathophysiological evidence suggesting that it may even be harmful. Differentiating the causes of adynamic bone in advanced chronic kidney disease informs osteoporosis treatmentKidney InternationalVol. 100Issue 3PreviewPatients with chronic kidney disease (CKD) have an increased fracture risk because of impaired bone quality and quantity. Low bone mineral density predicts fracture risk in all CKD stages, including advanced CKD (CKD G4-5D). Pharmacological therapy improves bone mineral density and reduces fracture risk in moderate CKD. Its efficacy in advanced CKD remains to be determined, although pilot studies suggest a positive effect on bone mineral density. Currently, antiresorptive agents are the most commonly prescribed drugs for the prevention and therapy of osteoporosis. Full-Text PDF Open Access
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