CKD-MBD; bone mineral density; chronic renal insufficiency; skeletal fragility; treatment; vertebral fractures
Abstract :
[en] Skeletal fragility has long been overlooked by the nephrology community, despite patients with chronic kidney disease (CKD) facing double the risk of hip fracture compared with the general population. Consequently, the term CKD-associated osteoporosis was recently coined to increase awareness. In this context, vertebral fractures are even less studied. Vertebral fractures predict increased fracture risk, and especially in advanced CKD show a strong association with aortic and iliac vascular calcifications, and cardiovascular events such as myocardial infarction. The scope of the present consensus paper is to comprehensively discuss the management of skeletal fragility in CKD patients, from diagnosis to treatment, with a particular focus on vertebral fractures in CKD G4-G5D.
Disciplines :
Laboratory medicine & medical technology Public health, health care sciences & services
Author, co-author :
Fusaro, Maria ; National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa ; Department of Medicine, University of Padova, Padova, Italy
Chandran, Manju; Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Outram Road, Singapore and DUKE NUS Medical School, Singapore, Outram Road, Singapore
Nickolas, Thomas ; Department of Medicine, Division of Nephrology, Columbia University, New York, NY, USA
Ferrari, Serge ; Service of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland
Cossettini, Althea; Post-Graduate School of Specialization in Nephrology, University of Milano, Milano, Italy
Ebeling, Peter R ; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
Closkey, Eugene Mc ; Department of Oncology & Metabolism, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
Harvey, Nicholas ; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK ; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Pierroz, Dominque D; International Osteoporosis Foundation (IOF), Nyon, Switzerland
Cannata-Andia, Jorge; Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Retic REDinREN-ISCIII, Avda. Roma, sn., 33011 ; Department of Medicine, Universidad de Oviedo, Oviedo, Spain
Cheung, Angela; Department of Medicine, University Health Network ; University of Toronto, Ontario, Canada
Guglielmi, Giuseppe; Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy
Glüer, Claus; Univeristy of Kiel, Germany
Foldes, Joseph; Department of Chemical Pathology, Sackler School of Medicine, University of Tel Aviv, Israel
W, Lems; Amsterdam UMC, Department of Rheumatology, Amsterdam, the Netherlands
Trombetti, Andrea; Division of Bone Diseases, Department of Medicine, Geneva University Hospitals ; Faculty of Medicine, Geneva, Switzerland
Mithal, Ambrish; Institute of Endocrinology and Diabetes, Max Healthcare, Saket, New Delhi, India
Napoli, Nicola; RU of Endocrinology and Diabetes, Campus Bio-Medico University of Rome and Fondazione Policlinico Campus Bio-Medico, Rome, Italy, Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
Haarhaus, Mathias ; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital ; Diaverum Sweden, Stockholm, Sweden
Ferraro, Pietro Manuel ; Division of Nephrology, Department of Medicine, University of Verona and Azienda Ospedaliera Univeristaria Integrata, Verona, Italy
Bellasi, Antonio; Service of Nephrology, Ospedale Regionale di Lugano, Ospedale Civico, Ente Ospedaliero Cantonale, Lugano, Switzerland
Moyses, Rosa; LIM 16, Nephrology Department, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
Evenepoel, Pieter ; Department of Nephrology, KU Leuven University Hospitals Leuven, Leuven, Belgium
Jørgensen, Hanne Skou ; Department of Nephrology, KU Leuven University Hospitals Leuven, Leuven, Belgium ; Department of Clinical Medicine, Aarhus University, Aarhus and 31Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique ; WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium - Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
Halbout, Philippe; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Bover, Jordi; Nephrology Department, University Hospital Germans Trias i Pujol & REMAR-IGTP Group, RICORS2040 network, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Badalona, Catalonia, Spain
Gallieni, Maurizio ; Department of Biomedical and Clinical Sciences 'Luigi Sacco', Università di Milano, Milano and Division of Nephrology ; Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Fatebenefratelli Hospital, Milan, Italy
Salam, Syazrah ; Sheffield Kidney Institute, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, United Kingdom
Eastell, Richard ; Mellanby Centre for Bone Research, Medical School, University of Sheffield, Sheffield, United Kingdom
Hansen, Ditte ; Department of Nephrology Copenhagen University Hospital - Herlev, Copenhagen, Denmark
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Brandi, Maria L; F.I.R.M.O. Italian Foundation for Research on Bone Disease, Florence, Italy
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