The Japanese Journal of Clinical Dialysis Vol.31 No.6(4-3)

Theme Testify the concepts of renal osteodystrophy and chronic kidney disease-bone and mineral disorder (CKD-MBD)
Title Preventing low-turnover bone disease in chronic kidney disease patients and improving their clinical outcomes
Publish Date 2015/06
Author Keiichi Sumida Nephrology Center, Toranomon Hospital
Author Junichi Hoshino Nephrology Center, Toranomon Hospital
Author Yoshifumi Ubara Nephrology Center, Toranomon Hospital
[ Summary ] The increasing prevalence of diabetic nephropathy and the increasing elderly population, has led to an increased number of patients with chronic kidney disease (CKD). Recent improvements in treatment of secondary hyperparathyroidism have contributed to preventing high-turnover bone diseases such as that associated with osteitis fibrosa. Low-turnover bone diseases cases, particularly adynamic bone disease, have increased in number. Adynamic bone disease in patients with CKD is an important concern because it may contribute to a potential for increased risk of fractures and cardiovascular disease which are also associated with increased mortality. Recently, once-daily teriparatide administration has become available in Japan to treat osteoporosis in patients at high risk of fractures. However, its efficacy and safety in patient with CKD with low-turnover bone disease remains unclear. Further investigations are necessary to establish optimal strategies for prevention and treatment in those patients to improve clinical outcomes.
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