Treatment of osteoporosis in renal insufficiency.

Abstract:

:Patients with osteoporosis often have chronic kidney disease (CKD). CKD is associated with bone and mineral disturbances, renal osteodystrophy, which like osteoporosis leads to a higher risk of fractures. Bisphosphonates are first-line therapy for osteoporosis; however, these are contra-indicated in patients with a GFR <30 ml/min. In this article, we have reviewed the diagnosis and treatment of osteoporosis in moderate to severe renal failure from data of clinical trials. Results have shown that osteoporosis patients and severe CKD with no signs of renal osteodystrophy, oral bisphosphonates (risedronate) seem to be a safe choice. Renal function and PTH should subsequently be monitored strictly. Denosumab, with regularly monitoring of calcium and adequate vitamin D levels or raloxifene are a possible second choice. In any case, one should be certain that there is no adynamic bone before treatment can be started. If there is any doubt, bone biopsies should be taken.

journal_name

Clin Rheumatol

journal_title

Clinical rheumatology

authors

Schipper LG,Fleuren HW,van den Bergh JP,Meinardi JR,Veldman BA,Kramers C

doi

10.1007/s10067-015-2883-4

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

1341-5

issue

8

eissn

0770-3198

issn

1434-9949

journal_volume

34

pub_type

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