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[慢性肾脏病患者的骨质疏松症治疗]

[Osteoporosis treatment for patients with chronic kidney disease].

作者信息

Konishi Yoshio

出版信息

Nihon Rinsho. 2015 Oct;73(10):1723-7.

Abstract

Osteoporosis is defined as a condition of impairment in bone strength and predisposes individuals to an increased risk of fractures. The risk of fragility fracture is shown to be high in patients with chronic kidney disease (CKD). Osteoporosis treatment for patients with CKD G1-3 should not differ from treatment for patients without CKD, as long as there are no accompanying hyperparathyroidism and hyperphosphatemia that indicate the co-existence of CKD -mineral and bone disorder. However, there are few published data on osteoporosis treatment for patients with CKD G4, 5. So, considerations for current pharmacologic therapy (such as bisphosphonate, denosumab, teriparatide, and raloxifene) should be a thoughtful and open discussion with these patients.

摘要

骨质疏松症被定义为一种骨强度受损的病症,会使个体面临骨折风险增加的情况。慢性肾脏病(CKD)患者发生脆性骨折的风险较高。CKD G1 - 3期患者的骨质疏松症治疗与非CKD患者的治疗不应有差异,只要不存在表明同时存在CKD - 矿物质和骨异常的伴随甲状旁腺功能亢进和高磷血症。然而,关于CKD G4、5期患者骨质疏松症治疗的已发表数据很少。因此,对于当前的药物治疗(如双膦酸盐、地诺单抗、特立帕肽和雷洛昔芬),应与这些患者进行深入且开放的讨论。

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