Paget's Disease of Bone and Chronic Kidney Disease: A Review

Introduction: Paget's disease of bone (PDB), the second most common bone disease after osteoporosis, is still of unknown etiology and thus deserves attention. PDB and chronic kidney disease (CKD) are chronic diseases characterized by alterations in bone turnover, mineralization, volume, and strength. Both conditions carry an increased cardiovascular risk, as well as increased morbidity and mortality. Both are common in the Western world and primarily affect men over 50 years of age. Despite these similarities, little data exists on their coexistence. Purpose and Methodology: By evaluating the available literature, we found extensive documentation on individual diseases, which has led to consolidated guidelines. The coexistence of the two diseases has provided sporadic studies describing individual cases or small case series. More limited information is available on patients who have received or are eligible for kidney transplants and also have PDB. This narrative (non-systematic) review aims to examine the topic with a particular focus on the relationship between PDB and CKD, especially concerning issues around kidney transplantation. The overlapping factors of the two diseases, and their impact on PDB diagnosis and treatment are discussed. Additionally, examining CKD patients may offer valuable insights for the design of prospective longitudinal or cross-sectional studies aimed at expanding our understanding of PDB. Limitations: The different points of discussion that emerged from the examination of this topic may be useful in the management of PDB-CKD patients but, at the moment, there are not enough data available to draw definitive conclusions to support clinical practice. Conclusions and Future Directions: The coexistence of PDB and CKD is not a rare phenomenon; studying patients with both diseases could provide insights into new research avenues. Above all, and more immediately, attention to the coexistence of the two diseases could improve patient management with personalized choices based on their renal function.