在患有慢性病的患者中,骨折的挑战
Andrea G Kattah1, Silvia M Titan1, Robert A Wermers2
1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
概括
患有慢性病 (CKD) 的患者由于复杂的骨疾病而面临更高的骨折风险. 目前对CKD骨病和骨折预防的诊断和治疗指南是不够的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 骨的新陈代谢 骨的新陈代谢
- 老年病的医生 老年病的医生
背景情况:
- 与普通人群相比,患有慢性病 (CKD) 的人具有明显增加的骨折风险.
- 慢性病患者的骨折与增加的死亡率和降低生活质量有关.
- 在一般人群中评估骨病和骨折风险的标准方法并不直接适用于CKD患者.
研究的目的:
- 审查CKD-矿物骨疾病 (CKD-MBD) 的病理生理学.
- 评估CKD当前的骨折风险评估策略.
- 检查CKD患者骨病的治疗选择.
主要方法:
- 使用PubMed.com进行了全面的文献审查.
- 包括的研究重点是CKD-MBD病理生理学,骨折风险评估和治疗选择.
主要成果:
- 在CKD中,骨折风险增加源于骨周转,矿物化和体积 (TMV) 的复杂相互作用,加之是球膜过率下降.
- 诊断脏骨质疏松症需要的不仅仅是骨密度和传统的骨质疏松症风险因素.
- 现有的骨折风险工具在CKD人群中存在局限性.
- 治疗决策必须考虑TMV组件,CKD阶段和并发症,尽管TMV评估尚未建立.
结论:
- 关于专门针对CKD患者的骨折预防治疗的有效性和安全性的数据有限.
- 迫切需要更清晰的指导方针来诊断,分层骨折风险和治疗慢性脏病中的骨病.
- 新兴的骨质疏松症药物需要更新CKD骨管理的临床指南.
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