Fractures in chronic kidney disease: pursuing the best screening and management

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art_GOLDENSTEIN_Fractures_in_chronic_kidney_disease_pursuing_the_best_2015.PDF (221.98 KB)
Citações na Scopus
26
Tipo de produção
article
Data de publicação
2015
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
JAMAL, Sophie A.
Citação
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, v.24, n.4, p.317-323, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose of review Osteoporotic fractures are common and cause increased sickness and death. Men and women with chronic kidney disease (CKD) are at particularly high risk of osteoporotic fractures. Currently, however, there are no guidelines concerning noninvasive methods to assess fracture risk in CKD. Further, approved treatments to prevent fractures in otherwise healthy men and women are only recommended for use with caution in those with CKD. This review focuses on the recent data that support the use of noninvasive methods to assess fracture risk in CKD and highlights new therapies that could be used in fracture prevention in CKD. Recent findings Data from prospective studies demonstrate that low bone mineral density predicts fracture in CKD patients. Post-hoc analyses demonstrate that agents approved for the treatment of postmenopausal osteoporosis (bisphosphonates, denosumab and teriparatide) when given to those with CKD are well tolerated and potentially efficacious with respect to fracture risk reduction. Summary To date, patients, and nephrologists taking care of them, have largely ignored fracture risk assessment and treatment in CKD. This should change given recent data. Further studies are needed, specifically bone histomorphometric studies, which will increase our understanding of CKD-mineral bone disease (MBD) pathophysiology, and randomized clinical trials of therapy in patients with CKD.
Palavras-chave
bone disease, bone histomorphometry, CKD-MBD, fracture, osteoporosis, osteoporosis therapy
URI
https://observatorio.fm.usp.br/handle/OPI/13572
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/16
Artigos e Materiais de Revistas Científicas - ODS/03