October - December 2015, Volume 11, Issue 4

Pascanu I, Neagoe RM

Management of Fragility Fracture in Chronic Kidney Disease

Acta Endo (Buc) 2015, 11 (4): 492-500
doi: 10.4183/aeb.2015.492

kidney disease (CKD), a growing public health issue, than in general population. The key issue in management of fragility fracture in CKD patients is determining whether fractures have occurred as a result of qualitative abnormalities (consequences of renal osteodystrophy or CKD-mineral and bone disorder), a reduced bone mineral density (osteoporosis) or a combination of both. In CKD patients bone histomorphometry is the gold standard for evaluating bone quality and strength, but the routine use of this method is not practical. Fracture risk can be assessed in this population by DEXA (Dual-Energy X-Ray Absorptiometry), but biochemical markers, like intact PTH and bone-specific alkaline phosphatase may be helpful. The new and emerging high resolution imaging tools need more studies for a correct evaluation of their utility in predicting fracture risk. Pharmacological therapies for fragility fracture based on current understanding of the metabolic disturbances in CKD will be reviewed. Antiresorptive and anabolic agents used in the treatment of osteoporosis are discussed with special focus on CKD population.

Keywords: CKD, fragility fracture, mineral bone disorder.

Correspondence: Ionela Pascanu MD, University of Medicine and Pharmacy, Dept. of Endocrinology, 38 Gh. Marinescu, Târgu Mures, 540139, Romania, E-mail: iopascanu@gmail.com