Authors: Lydia G Schipper Hanneke W H A Fleuren Joop P W van den Bergh Johan R Meinardi Bart A J Veldman Cornelis Kramers
Publish Date: 2015/01/29
Volume: 34, Issue: 8, Pages: 1341-1345
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 firstline therapy for osteoporosis however these are contraindicated 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
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