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Kidney-induced osteoporosis: a new entity with a novel therapeutic approach

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Summary:Over the past century, important scientific advances have been made regarding the complex pathophysiology of bone disease in renal patients. Bone disease in renal patients is included in a wider spectrum of disease, the CKD-mineral bone disorders (CKD-MBD). Older patients with CKD can present with both age-related osteoporosis and renal osteodystrophy. Clinicians are now challenged with the need to prevent fracture in these CKD patients, where the efficacy and safety of pharmacologic agents used for the general osteoporotic population have not been studied. Treatment of renal osteodystrophy has been focused on control of the parathyroid secretion with calcitriol, vitamin D analogs and calcimimetic agents. However, there is an increase in fractures with aging in patients with CKD, suggesting that these patients also have the fracture risk factors common to the general population, such as age. Pharmacologic agents, such as teriparatide, denosumab and romosozumab have been developed for osteoporosis treatment with a direct effect on bone cell activity, osteoblasts and osteoclasts. This article reviews the derangements in bone turnover, mineralization and volume in CKD-MBD. In addition, we will also discuss strategies to manage osteoporosis in CKD and the available data on the new pharmacological agents in CKD-patients.
Main Authors:Pereira,Ana Beatriz de Oliveira
Other Authors:Frazão,João Miguel Machado Dória
Subject:chronic kidney disease-mineral bone disease denosumab osteoporosis renal osteodystrophy romosozumab teriparatide
Year:2020
Country:Portugal
Document type:article
Access type:open access
Associated institution:Fundação para a Ciência e Tecnologia
Language:English
Origin:SciELO Portugal
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author Pereira,Ana Beatriz de Oliveira
author2 Frazão,João Miguel Machado Dória
author2_role author
author_facet Pereira,Ana Beatriz de Oliveira
Frazão,João Miguel Machado Dória
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Pereira,Ana Beatriz de Oliveira\"},{\"Person.name\":\"Frazão,João Miguel Machado Dória\"}]
datacite.creators.creator.creatorName.fl_str_mv Pereira,Ana Beatriz de Oliveira
Frazão,João Miguel Machado Dória
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv chronic kidney disease-mineral bone disease
denosumab
osteoporosis
renal osteodystrophy
romosozumab
teriparatide
datacite.titles.title.fl_str_mv Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
dc.creator.none.fl_str_mv Pereira,Ana Beatriz de Oliveira
Frazão,João Miguel Machado Dória
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692020000200005
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.34 n.2 2020
dc.subject.none.fl_str_mv chronic kidney disease-mineral bone disease
denosumab
osteoporosis
renal osteodystrophy
romosozumab
teriparatide
dc.title.fl_str_mv Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Over the past century, important scientific advances have been made regarding the complex pathophysiology of bone disease in renal patients. Bone disease in renal patients is included in a wider spectrum of disease, the CKD-mineral bone disorders (CKD-MBD). Older patients with CKD can present with both age-related osteoporosis and renal osteodystrophy. Clinicians are now challenged with the need to prevent fracture in these CKD patients, where the efficacy and safety of pharmacologic agents used for the general osteoporotic population have not been studied. Treatment of renal osteodystrophy has been focused on control of the parathyroid secretion with calcitriol, vitamin D analogs and calcimimetic agents. However, there is an increase in fractures with aging in patients with CKD, suggesting that these patients also have the fracture risk factors common to the general population, such as age. Pharmacologic agents, such as teriparatide, denosumab and romosozumab have been developed for osteoporosis treatment with a direct effect on bone cell activity, osteoblasts and osteoclasts. This article reviews the derangements in bone turnover, mineralization and volume in CKD-MBD. In addition, we will also discuss strategies to manage osteoporosis in CKD and the available data on the new pharmacological agents in CKD-patients.
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person_str_mv Pereira,Ana Beatriz de Oliveira
Frazão,João Miguel Machado Dória
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spelling Kidney-induced osteoporosis: a new entity with a novel therapeutic approachPereira,Ana Beatriz de OliveiraFrazão,João Miguel Machado Dóriachronic kidney disease-mineral bone diseasedenosumabosteoporosisrenal osteodystrophyromosozumabteriparatideopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692020000200005URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692020000200005URLHasVersion2020-06-01Over the past century, important scientific advances have been made regarding the complex pathophysiology of bone disease in renal patients. Bone disease in renal patients is included in a wider spectrum of disease, the CKD-mineral bone disorders (CKD-MBD). Older patients with CKD can present with both age-related osteoporosis and renal osteodystrophy. Clinicians are now challenged with the need to prevent fracture in these CKD patients, where the efficacy and safety of pharmacologic agents used for the general osteoporotic population have not been studied. Treatment of renal osteodystrophy has been focused on control of the parathyroid secretion with calcitriol, vitamin D analogs and calcimimetic agents. However, there is an increase in fractures with aging in patients with CKD, suggesting that these patients also have the fracture risk factors common to the general population, such as age. Pharmacologic agents, such as teriparatide, denosumab and romosozumab have been developed for osteoporosis treatment with a direct effect on bone cell activity, osteoblasts and osteoclasts. This article reviews the derangements in bone turnover, mineralization and volume in CKD-MBD. In addition, we will also discuss strategies to manage osteoporosis in CKD and the available data on the new pharmacological agents in CKD-patients.Sociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.34 n.2 2020text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature
spellingShingle Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
Pereira,Ana Beatriz de Oliveira
chronic kidney disease-mineral bone disease
denosumab
osteoporosis
renal osteodystrophy
romosozumab
teriparatide
status SINGLETON
subject.fl_str_mv chronic kidney disease-mineral bone disease
denosumab
osteoporosis
renal osteodystrophy
romosozumab
teriparatide
title Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
title_full Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
title_fullStr Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
title_full_unstemmed Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
title_short Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
title_sort Kidney-induced osteoporosis: a new entity with a novel therapeutic approach
topic chronic kidney disease-mineral bone disease
denosumab
osteoporosis
renal osteodystrophy
romosozumab
teriparatide
topic_facet chronic kidney disease-mineral bone disease
denosumab
osteoporosis
renal osteodystrophy
romosozumab
teriparatide
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692020000200005
visible 1