Division of Nephrology, University Hospitals Leuven, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
Centre for Nephrology, Royal Free Campus, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK.
Osteoporos Int. 2021 Dec;32(12):2397-2405. doi: 10.1007/s00198-021-05975-7. Epub 2021 Jun 15.
The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) CKD-MBD working group, in collaboration with the Committee of Scientific Advisors of the International Osteoporosis Foundation, published a position paper for the diagnosis and management of osteoporosis in patients with CKD stages 4-5D (eGFR < 30 ml/min 1.73 m). The present article reports and summarizes the main recommendations included in this 2021 document. The following areas are reviewed: diagnosis of osteoporosis; risk factors for fragility fractures; fracture risk assessment; intervention thresholds for pharmacological intervention; general and pharmacological management of osteoporosis; monitoring of treatment, and systems of care, all in patients with CKD stages 4-5D. Guidance is provided for clinicians caring for CKD stages 4-5D patients with osteoporosis, allowing for a pragmatic individualized diagnostic and therapeutic approach as an alternative to current variations in care and treatment nihilism.
欧洲肾脏协会-欧洲透析和移植协会（ERA-EDTA）慢性肾脏病矿物质和骨异常（CKD-MBD）工作组与国际骨质疏松基金会科学顾问委员会合作，发布了一份针对慢性肾脏病 4-5 期（eGFR < 30 ml/min/1.73 m ）患者骨质疏松症的诊断和管理的立场文件。本文报告并总结了该 2021 年文件中的主要建议。以下领域进行了回顾：骨质疏松症的诊断；脆性骨折的危险因素；骨折风险评估；药物干预的干预阈值；慢性肾脏病 4-5 期患者的骨质疏松症的一般和药物治疗；以及治疗监测和护理系统。为治疗慢性肾脏病 4-5 期骨质疏松症患者的临床医生提供了指导，允许采用实用的个体化诊断和治疗方法，以替代当前护理和治疗虚无主义的差异。
