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.
Original language | English |
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Pages (from-to) | 1341-1345 |
Number of pages | 5 |
Journal | Clinical Rheumatology |
Volume | 34 |
Issue number | 8 |
DOIs | |
Publication status | Published - Aug 2015 |
Keywords
- Bisphosphonates
- Denosumab
- Osteoporosis
- Renal insufficiency
- CHRONIC KIDNEY-DISEASE
- POSTMENOPAUSAL WOMEN
- POOLED ANALYSIS
- BONE-DISEASE
- FRACTURE
- IBANDRONATE
- BISPHOSPHONATE
- HYPOCALCEMIA
- SAFETY
- HYPERPARATHYROIDISM