Osteoporosis Management in Patients with Chronic Kidney Disease
Author(s): Mohammad Tinawi
The definition of osteoporosis in the general population according to the World Health Organization (WHO) is a T-score ≤ -2.5, or the presence of a low trauma fracture irrespective of bone mineral density (BMD). Osteopenia is defined by the WHO as T-score between -1 to -2.5. The prevalence of osteoporosis is higher in women with and without chronic kidney disease (CKD). In patients with CKD, osteoporosis falls within the spectrum of chronic kidney disease mineral and bone disorder (CKD-MBD). Kidney Disease Improving Global Outcome (KDIGO) CKD-MBD guidelines recommend measurements of BMD in patients with stage 3 or higher CKD to assess fracture risk. Many pharmacological options exist for the treatment of osteoporosis in the general population. There are no clinical trials in patients with CKD-MBD. Recommendations are based on expert opinion and post hoc analyses of major osteoporosis trials in the general population.