Diagnosis and Management of Cirrhosis-Related Osteoporosis
Lívia Alves Amaral Santos1, Fernando Gomes Romeiro1
1Department of Internal Medicine, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Distrito de Rubião Jr., 18 608 917 Botucatu, SP, Brazil.
Insights
Cirrhosis patients often develop osteoporosis, a complication that persists even after liver transplantation due to immunosuppressants. This review details osteoporosis in cirrhosis, covering risk factors, diagnosis, and treatments.
Area of Science:
- Hepatology
- Endocrinology
- Bone Metabolism
Background:
- Cirrhosis management has improved, yet non-liver complications like osteoporosis are often overlooked.
- Osteoporosis is a persistent complication post-liver transplantation, exacerbated by immunosuppressive therapy.
Purpose of the Study:
- To analyze bone conditions in cirrhotic patients, focusing on osteoporosis.
- To discuss risk factors, pathophysiology, diagnosis, screening, and treatment of osteoporosis in cirrhosis.
Main Methods:
- Review of definitions for bone conditions in cirrhotic patients.
- Analysis of risk factors, pathophysiology, diagnosis, screening, and treatment strategies.
- Presentation of data on osteoporosis in cirrhosis and specific therapies.
Main Results:
- Osteoporosis is a significant and often unresolved complication of cirrhosis.
- Bone loss can worsen post-liver transplantation due to immunosuppressants.
- Specific therapeutic approaches for osteoporosis in cirrhosis and post-transplant are discussed.
Conclusions:
- Osteoporosis requires dedicated attention in cirrhosis management.
- Effective screening and treatment strategies are crucial for improving patient outcomes.
- Further research into managing bone health in liver transplant recipients is warranted.
Abstract:
Management of cirrhosis complications has greatly improved, increasing survival and quality of life of the patients. Despite that, some of these complications are still overlooked and scarcely treated, particularly those that are not related to the liver. This is the case of osteoporosis, the only cirrhosis complication that is not solved after liver transplantation, because bone loss often increases after immunosuppressant therapy. In this review, the definitions of bone conditions in cirrhotic patients are analyzed, focusing on the more common ones and on those that have the largest impact on this population. Risk factors, physiopathology, diagnosis, screening strategies, and treatment of osteoporosis in cirrhotic patients are discussed, presenting the more striking data on this issue. Therapies used for particular conditions, such as primary biliary cirrhosis and liver transplantation, are also presented.
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