Moe Sharon M
Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut Street, R2-202, Indianapolis, IN, 46202, USA.
Department of Medicine, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA.
Curr Osteoporos Rep. 2017 Jun;15(3):194-197. doi: 10.1007/s11914-017-0364-1.
Chronic kidney disease (CKD) affects nearly 10% of the population. The incidence of fractures in population studies demonstrate an increase with worsening stages of kidney disease suggesting specific CKD related causes of fracture.
The increase in fractures with CKD most likely represents disordered bone quality due to the abnormal bone remodeling from renal osteodystrophy. There is also an increase in fractures with age in patients with CKD, suggesting that patients with CKD also have many fracture risk factors common to patients without known CKD. Osteoporosis is defined by the National Institutes of Health as "A skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Bone strength reflects the integration of two main features: bone quantity and bone quality." Thus, CKD-related fractures can be considered a type of osteoporosis-where the bone quality is additionally impaired above that of age/hormonal-related osteoporosis. Perhaps using the term CKD-induced osteoporosis, similar to steroid-induced osteoporosis, will allow patients with CKD to be studied in trials investigating therapeutic agents. In this series, we will examine how CKD-induced osteoporosis may be diagnosed and treated.
慢性肾脏病（CKD）影响着近10%的人口。人群研究中骨折的发生率显示，随着肾脏疾病阶段的恶化而增加，提示存在与CKD相关的特定骨折原因。
CKD患者骨折增加很可能是由于肾性骨营养不良导致骨重塑异常，进而引起骨质量紊乱。CKD患者的骨折发生率也随年龄增加，这表明CKD患者也有许多与无CKD患者共有的骨折危险因素。美国国立卫生研究院将骨质疏松定义为“一种以骨强度受损为特征的骨骼疾病，易导致骨折风险增加。骨强度反映了两个主要特征的综合：骨量和骨质量。”因此，与CKD相关的骨折可被视为一种骨质疏松症——其骨质量在年龄/激素相关骨质疏松症的基础上进一步受损。或许使用“CKD诱发的骨质疏松症”这一术语，类似于类固醇诱发的骨质疏松症，将使CKD患者能够在研究治疗药物的试验中得到研究。在本系列中，我们将探讨如何诊断和治疗CKD诱发的骨质疏松症。
