Updates in CKD-Associated Osteoporosis

Curr Osteoporos Rep. 2018 Dec;16(6):712-723. doi: 10.1007/s11914-018-0491-3.

Abstract

Purpose of review: Chronic kidney disease (CKD) is associated with bone loss and fractures. The purpose of this review is to provide clinicians with an overview of the underlying pathogenesis of CKD-associated osteoporosis, and a summary of the current diagnostic and therapeutic approaches to this disease.

Recent findings: In 2017, the Kidney Disease Improving Global Outcomes Committee on Bone Quality updated their guidelines to include screening for osteoporosis and fracture risk by dual energy X-ray absorptiometry in patients with CKD. Once a diagnosis of osteoporosis and/or fracture risk is established, it is not clear how nephrologists should manage their patients. Patients with CKD should be screened for CKD-associated osteoporosis and considered for strategies that prevent bone loss and fractures. Assessment of bone turnover via imaging, biochemical testing, or bone biopsy can help guide the choice of therapy. Randomized controlled trials are needed to assess safety and efficacy of treatments to prevent bone loss and fractures.

Keywords: CKD-MBD; Osteoporosis; Renal osteodystrophy.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Absorptiometry, Photon
  • Bone Density
  • Bone Density Conservation Agents / therapeutic use*
  • Humans
  • Osteoporosis / drug therapy
  • Osteoporosis / etiology*
  • Osteoporosis / metabolism
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / metabolism

Substances

  • Bone Density Conservation Agents