COMMENTARY ON MANAGEMENT OF OSTEOPOROSIS IN ADVANCED CKD: COMMON VIEW OF A NEPHROLOGIST AND A BONE SPECIALIST

In this commentary, we present our clinical view of low BMD management in CKD-MBD patients. Our opinion is supported by 3 basal components: (1) our thorough knowledge of current evidence and our long-term clinical practice; (2) close cooperation between nephrologists and bone specialists; and (3) ou...

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Published inEndocrine practice Vol. 25; no. 2; pp. 193 - 196
Main Authors Brunerova, Ludmila, Palicka, Vladimir, Sulkova, Sylvie Dusilova
Format Journal Article
LanguageEnglish
Published United States Elsevier Limited 01.02.2019
Subjects
Bone density
Hemodialysis
Humans
Kidney diseases
Nephrologists
Osteoporosis
Renal Insufficiency, Chronic
Systematic review
Vitamin D
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Summary:In this commentary, we present our clinical view of low BMD management in CKD-MBD patients. Our opinion is supported by 3 basal components: (1) our thorough knowledge of current evidence and our long-term clinical practice; (2) close cooperation between nephrologists and bone specialists; and (3) our established management, fully respecting available evidence, but also working with clinical judgement after consultation in specific cases. Patients with CKD grades 1 to 3a (i.e. without biochemical disturbances of calcium-phosphate metabolism, which start usually at stage CKD3b) are diagnosed (including BMD assessment) and treated identically as a general population. Nevertheless, the therapeutic response of CKD1 to 3a patients with intrinsic renal disease to specific anti-osteoporotic agents may differ from CKD1 to 3a postmenopausal women without signs of overt renal disease who were included in large registration trials.
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ISSN:1530-891X
1934-2403
DOI:10.4158/EP-2018-0311