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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Rethinking Bone Disease in Kidney Disease.

Matthew J Damasiewicz1,2, Thomas L Nickolas3

  • 1Department of Nephrology Monash Health Clayton Australia.

JBMR Plus
|November 22, 2018
PubMed
Summary

Renal osteodystrophy (ROD) significantly increases fracture risk in chronic kidney disease (CKD) patients. New diagnostic and management strategies are crucial to address high fracture rates and improve outcomes in CKD-MBD.

Keywords:
BONE DISEASECKDCKD‐MBDESKDFRACTURESOSTEOPOROSIS

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Area of Science:

  • Nephrology
  • Endocrinology
  • Orthopedics

Background:

  • Renal osteodystrophy (ROD) is a bone complication of chronic kidney disease mineral and bone disorder (CKD-MBD).
  • Hormonal and metabolic disturbances in kidney disease impair bone quality, increasing fracture risk.
  • Fracture rates are alarmingly high in end-stage kidney disease (ESKD) patients compared to the general population.

Purpose of the Study:

  • To review the epidemiology, pathology, diagnosis, and management of ROD.
  • To highlight the need for improved diagnostic and management strategies for ROD.
  • To emphasize the necessity of fracture prevention in kidney disease patients.

Main Methods:

  • Review of current literature on ROD in kidney disease patients.
  • Discussion of advances in noninvasive bone quality and strength measurement.
  • Analysis of diagnostic and therapeutic challenges in clinical practice.

Main Results:

  • ROD significantly elevates fracture risk and morbidity/mortality in CKD patients.
  • Current noninvasive diagnostic methods for ROD type are insufficient.
  • A paradigm shift in ROD diagnosis and management is needed.

Conclusions:

  • There is a pressing need for greater awareness and implementation of fracture prevention strategies in kidney disease.
  • Further research is required for accurate noninvasive ROD assessment.
  • Clinical studies of osteoporosis therapies and development of CKD-specific treatments are essential.