Academic Journal

Diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy

Bibliographic Details
Title: Diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy
Authors: Craig B. Langman, Miroslaw T Smogorzewski, Shaul G. Massry, Justin Silver, James T. McCarthy, Kevin J. Martin, Eduardo M Slatopolsky, Jack W. Coburn, Otto Mehls, Masafumi Fukagawa, Hartmut H. Malluche, Klaus Olgaard, Giorgio Coen, Linda McCann, Isidro B. Salusky
Source: American Journal of Kidney Diseases. 43:558-565
Publisher Information: Elsevier BV, 2004.
Publication Year: 2004
Subject Terms: Adult, Chronic Kidney Disease-Mineral and Bone Disorder, Biopsy, Calcium-Binding Proteins, Sevelamer, Bone and Bones, 3. Good health, 03 medical and health sciences, Absorptiometry, Photon, 0302 clinical medicine, Parathyroid Hormone, Renal Dialysis, Polyamines, Epoxy Compounds, Humans, Bone Remodeling, Polyethylenes, Vitamin D, Child, Biomarkers
Description: HE ABNORMALITIES of the skeleton in chronic kidney disease (CKD), collectively known as renal osteodystrophy, are an important cause of morbidity and decreased quality of life. In the management of patients with kidney disease, it is necessary to have a rational approach to the diagnosis and assessment of renal osteodystrophy in order to devise a treatment plan that hopefully will lead to an improved outcome. In the past, the term renal osteodystrophy was mainly equated only with abnormalities of bone turnover, but as described in the article by Cunningham and Sprague 1 in this same issue, renal osteodystrophy is a complex disorder of compromised bone strength in CKD patients. While osteoporosis is a term used to describe fragile bones prone to fracture in the general population and is most often assessed by dual x-ray absorptiometry (DEXA), renal osteodystrophy should be the principal term to describe fragile bones prone to fracture and other morbidities in CKD. Renal osteodystrophy is a function of bone turnover (assessed by bone biopsy), bone density (assessed by DEXA or quantitative CT [qCT]), and bone architecture, but the principal determinant of bone fragility in CKD is abnormal bone turnover. However, diagnosing and treating bone turnover abnormalities remains challenging. Our discussion group met to assess the current state of knowledge, understand the basis of our current therapy, and identify the information that needs to be gathered to improve the therapy of bone turnover and thereby improve the disorder of renal osteodystrophy. A number of important questions, listed in Table 1, were considered.
Document Type: Article
Language: English
ISSN: 0272-6386
DOI: 10.1053/j.ajkd.2003.12.003
Access URL: https://pubmed.ncbi.nlm.nih.gov/14981615
https://www.ncbi.nlm.nih.gov/pubmed/14981615
https://pubmed.ncbi.nlm.nih.gov/14981615/
https://europepmc.org/article/MED/14981615
https://www.sciencedirect.com/science/article/pii/S0272638603015816
https://www.ajkd.org/article/S0272-6386(03)01581-6/pdf
https://www.ajkd.org/article/S0272-6386(03)01581-6/fulltext
Rights: Elsevier TDM
Accession Number: edsair.doi.dedup.....8821cdae24242c7d9bf1526770a624d4
Database: OpenAIRE
Description
ISSN:02726386
DOI:10.1053/j.ajkd.2003.12.003