Chronic kidney disease and fragility fracture
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- 作者：Junichiro James Kazama
- 关键词：Fragility fracture ; Osteoporosis ; Chronic kidney disease ; related bone and mineral disease (CKD ; MBD) ; Fracture liaison
- 刊名：Clinical and Experimental Nephrology
- 出版年：2017
- 出版时间：March 2017
- 年：2017
- 卷：21
- 期：1-supp
- 页码：46-52
- 全文大小：458KB
- 刊物类别：Medicine
- 刊物主题：Nephrology; Urology;
- 出版者：Springer Japan
- ISSN：1437-7799
- 卷排序：21
文摘
Osteoporosis is defined simply as “a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Thus, any bone lesion that causes fragility fracture is osteoporosis, which has quite heterogeneous backgrounds. Chronic kidney disease-related bone and mineral disease (CKD-MBD) is defined as “a systemic disorder of mineral and bone metabolism due to CKD, which is manifested by abnormalities in bone and mineral metabolism and/or extra-skeletal calcification”. Although CKD-MBD is one of the possible causes of osteoporosis, we do not have evidences that CKD-MBD is the only or crucial determinant of bone mechanical strength in CKD patients. The risk of hip fracture is considerably high in CKD patients. Drugs that intervene in systemic mineral metabolism, indeed, lead to the improvement on bone histology in CKD patients. However, it remains unclear whether the intervention in systemic mineral metabolism also improves bone strength, today. Thus, the use of drugs that directly act on bone and the introduction of fracture liaison concept are promising strategies for fragility fracture prevention among CKD patients, as well as treatment for CKD-MBD.