Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
Over the past century, important scientific advances have been made regarding the complex pathophysiology of bone disease in renal patients. Bone disease in renal patients is included in a wider spectrum of disease, the CKD-mineral bone disorders (CKD-MBD). Older patients with CKD can present with b...
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| Published in | Portuguese journal of nephrology & hypertension Vol. 34; no. 2; pp. 92 - 100 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English Portuguese |
| Published |
Sociedade Portuguesa de Nefrologia
14.07.2020
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| Abstract | Over the past century, important scientific advances have been made regarding the complex pathophysiology of bone disease in renal patients. Bone disease in renal patients is included in a wider spectrum of disease, the CKD-mineral bone disorders (CKD-MBD). Older patients with CKD can present with both age-related osteoporosis and renal osteodystrophy. Clinicians are now challenged with the need to prevent fracture in these CKD patients, where the efficacy and safety of pharmacologic agents used for the general osteoporotic population have not been studied. Treatment of renal osteodystrophy has been focused on control of the parathyroid secretion with calcitriol, vitamin D analogs and calcimimetic agents. However, there is an increase in fractures with aging in patients with CKD, suggesting that these patients also have the fracture risk factors common to the general population, such as age. Pharmacologic agents, such as teriparatide, denosumab and romosozumab have been developed for osteoporosis treatment with a direct effect on bone cell activity, osteoblasts and osteoclasts. This article reviews the derangements in bone turnover, mineralization and volume in CKD-MBD. In addition, we will also discuss strategies to manage osteoporosis in CKD and the available data on the new pharmacological agents in CKD-patients. |
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| AbstractList | Over the past century, important scientific advances have been made regarding the complex pathophysiology of bone disease in renal patients. Bone disease in renal patients is included in a wider spectrum of disease, the CKD-mineral bone disorders (CKD-MBD). Older patients with CKD can present with both age-related osteoporosis and renal osteodystrophy. Clinicians are now challenged with the need to prevent fracture in these CKD patients, where the efficacy and safety of pharmacologic agents used for the general osteoporotic population have not been studied. Treatment of renal osteodystrophy has been focused on control of the parathyroid secretion with calcitriol, vitamin D analogs and calcimimetic agents. However, there is an increase in fractures with aging in patients with CKD, suggesting that these patients also have the fracture risk factors common to the general population, such as age. Pharmacologic agents, such as teriparatide, denosumab and romosozumab have been developed for osteoporosis treatment with a direct effect on bone cell activity, osteoblasts and osteoclasts. This article reviews the derangements in bone turnover, mineralization and volume in CKD-MBD. In addition, we will also discuss strategies to manage osteoporosis in CKD and the available data on the new pharmacological agents in CKD-patients. |
| Author | Pereira, Ana Frazão, João |
| AuthorAffiliation | University of Porto São João Hospital Center |
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| CorporateAuthor | INEB – National Institute of Biomedical Engineering, University of Porto, Portugal Institute of Investigation and Innovation in Health, University of Porto, Portugal Department of Nephrology, São João Hospital Center, Porto, Portugal Faculty of Medicine of the University of Porto |
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| Issue | 2 |
| Keywords | romosozumab teriparatide osteoporosis renal osteodystrophy denosumab chronic kidney disease-mineral bone disease |
| Language | English Portuguese |
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