Bone fragility fractures in CKD patients

Pimentel, Ana; Ureña-Torres, Pablo; Bover, Jordi; Fernandez-Martín, Jose Luis; Cohen-Solal, Martine

Affiliations

¹AURA Paris-Nord, Saint‐Ouen, France

²Necker Hospital, University of Paris Descartes, Department of Renal Physiology, Paris, France

³Fundació Puigvert, Universitat Autònoma, IIB Sant Pau, REDinREN, Nephrology Department, Barcelona, Catalonia, Spain

⁴Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), REDinREN del ISCIII, Hospital Universitario Central de Asturias. Universidad de Oviedo, Bone and Mineral Research Unit, Oviedo, Asturias, Spain

⁵INSERM U1132 & Université de Paris, Hôpital Lariboisière, Department of Rheumatology, Paris, France

Abstract and keywords

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.

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

Links

DOI: 10.1007/s00223-020-00779-z

PubMed: 33219822

WoS: 000591724500001

History

Received: 2020-10-08

Accepted: 2020-11-04

Online: 2020-11-21

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Cited By (1)

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2021	Cannata-Andía JB, Martín-Carro B, Martín-Vírgala J, Rodríguez-Carrio J, Bande-Fernández JJ, Alonso-Montes C, Carrillo-López N. Chronic kidney disease—mineral and bone disorders: pathogenesis and management. Calcif Tiss Int. April 2021;108(4):410-422.