4.4 Review

Bone Fragility Fractures in CKD Patients

Journal

CALCIFIED TISSUE INTERNATIONAL
Volume 108, Issue 4, Pages 539-550

Publisher

SPRINGER
DOI: 10.1007/s00223-020-00779-z

Keywords

Bone; Fracture; Bone mineral density; CKD-MBD; Phosphate; Calcium; Parathyroid hormone; Imaging

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Chronic kidney diseases are linked to bone loss, pain, and fractures, necessitating effective management and preventive measures to enhance skeletal health in CKD patients.
Chronic kidney diseases (CKD) are associated with mineral and bone diseases (MBD), including pain, bone loss, and fractures. Bone fragility related to CKD includes the risk factors observed in osteoporosis in addition to those related to CKD, resulting in a higher risk of mortality related to fractures. Unawareness of such complications led to a poor management of fractures and a lack of preventive approaches. The current guidelines of the Kidney Disease Improving Global Outcomes (KDIGO) recommend the assessment of bone mineral density if results will impact treatment decision. In addition to bone density, circulating biomarkers of mineral, serum bone turnover markers, and imaging techniques are currently available to evaluate the fracture risk. The purpose of this review is to provide an overview of the epidemiology and pathogenesis of CKD-associated bone loss. The contribution of the current tools and other techniques in development are discussed. We here propose a current view of how to better predict bone fragility and the therapeutic options in CKD.

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