Arazzi Marta, Di Fulvio Giorgia, Di Pietro Lorenzo Ottavio, Grabocka Xhensila, Longo Maria Olimpia, Micioni Gabriella, Pezzutto Alessandro, Piscitani Luca, Schiazza Alessandra, Silvestri Simona, Vigilante Giacinta, Amoroso Luigi, Bonomini Mario
Scuola di Specializzazione in Nefrologia, Università degli Studi "G. d'Annunzio", Chieti-Pescara, U.O.C. Clinica Nefrologica e Dialisi, Ospedale Clinicizzato "SS. Annunziata", Chieti.
G Ital Nefrol. 2017 Dec 5;34(Nov-Dec):2017-vol6.
Glucocorticoid-induced osteoporosis (GIO) is a major cause of secondary osteoporosis that starts early after the beginning of therapy even for low drug doses. Glucocorticoids are used for the treatment of immunologic nephropathies and in the setting of kidney transplant. In clinical practice, a number of algorithms are available; they allow us to estimate the long-term risk of major osteoporotic fracture; but none of them is specific for GIO. To date, the therapeutic approach comprises both general measures aimed at correcting calcium and vitamin D intake, and drugs (bisphosphonates, teriparatide, hormone replacement therapy, denosumab) that ameliorate bone mineral density and patient outcomes.
糖皮质激素性骨质疏松症（GIO）是继发性骨质疏松症的主要原因，即使药物剂量较低，在治疗开始后早期就会出现。糖皮质激素用于治疗免疫性肾病以及肾移植情况。在临床实践中，有多种算法可用；它们使我们能够估计主要骨质疏松性骨折的长期风险；但没有一种算法对GIO具有特异性。迄今为止，治疗方法包括旨在纠正钙和维生素D摄入量的一般措施，以及改善骨矿物质密度和患者预后的药物（双膦酸盐、特立帕肽、激素替代疗法、地诺单抗）。
