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proLékaře.cz / Journals / Clinical Osteology / 2019 - 4

Densitometry in patients with chronic kidney disease

Czech version

Authors: Brunerová Ludmila
Authors‘ workplace: II. interní klinika 3. LF UK a FNKV, Praha
Published in: Clinical Osteology 2019; 24(4): 192-197
Category:

Overview

Advanced chronic kidney disease (CKD G3b-5) as CKD-MBD (mineral and bone disorder associated with CKD) is connected with low bone mineral density (BMD) and significantly increased fracture risk (2–100x) that has a significant negative impact on quality of life and prognosis of these patients. Bone histomorphonetry represents the gold standard for diagnostics of CKD-MBD bone disorder subtypes, however, due to several reasons it is performed rarely in clinical practice. Thus, more attention is paid to noninvasive differential diagnostic procedures (DXA, markers of bone turnover). Original 2009 KDIGO (Kidney Disease Improving Global Outcomes) guidelines strongly did not recommend DXA in this population because of the absence of data on prediction of fracture risk and non-specificity of DXA in different CKD-MBD bone disorder subtypes). Nonetheless, the proof of fracture prediction by DXA and high prevalence of osteoporosis led to revision of KDIGO guidelines and practically routine recommendation of DXA in CKD G3b-5D patients with CKD-MBD and/or risk factors of osteoporosis (if the results changes the therapy). However, there are some specificities of DXA assessment in these patients (more significant impairment of cortical bone, over-assessment of BMD in lumbar spine and some advantages of laterogram).

Keywords:

chronic kidney disease – densitometry – fractures

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Labels
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology
Background theses for the formulation of guidelines on diagnosis and therapy metabolic bone disease as a part of CKD-MBD, with specific focus on low mineral bone content in DXA examination
Association between bone and vascular calcification: evidence from clinical studies
Bone disease in patients after organ transplantation
Calciphylaxis as a multidisciplinary problem: important information (not only) for clinical osteologists and case reports
ODPORÚČANIE SOMOK DLHODOBÁ LIEČBA OSTEOPORÓZY DENOSUMABOM
První biosimilár k léčbě osteoporózy v EU schválen!
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