Diagnosis and management of osteoporosis in chronic kidney disease stages 4 to 5D: a call for a shift from nihilism to pragmatism.
Pieter EvenepoelJ CunninghamS FerrariM HaarhausM K JavaidM-H Lafage-ProustD Prieto-AlhambraP U TorresJ Cannata-Andianull nullnull nullnull nullPublished in: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2021)
The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) CKD-MBD working group, in collaboration with the Committee of Scientific Advisors of the International Osteoporosis Foundation, published a position paper for the diagnosis and management of osteoporosis in patients with CKD stages 4-5D (eGFR < 30 ml/min 1.73 m2). The present article reports and summarizes the main recommendations included in this 2021 document. The following areas are reviewed: diagnosis of osteoporosis; risk factors for fragility fractures; fracture risk assessment; intervention thresholds for pharmacological intervention; general and pharmacological management of osteoporosis; monitoring of treatment, and systems of care, all in patients with CKD stages 4-5D. Guidance is provided for clinicians caring for CKD stages 4-5D patients with osteoporosis, allowing for a pragmatic individualized diagnostic and therapeutic approach as an alternative to current variations in care and treatment nihilism.
Keyphrases
- postmenopausal women
- bone mineral density
- chronic kidney disease
- risk assessment
- palliative care
- randomized controlled trial
- end stage renal disease
- healthcare
- small cell lung cancer
- body composition
- emergency department
- combination therapy
- pain management
- epidermal growth factor receptor
- clinical practice
- affordable care act
- chronic pain
- smoking cessation