| [ Summary ] |
Recently, guidelines on the management of glucocorticoid-induced osteoporosis (GIO) were published in Japan, advocating bisphosphonate be a first line drug for GIO. However, there are some difficulties in administering this drug for GIO in patients having chronic kidney disease (CKD). Monotherapy with bisphosphonate may enhance secondary hyperparathyroidism with CKD. Another problem is that CKD itself interferes the bone resorption marker, serum NTX, which is an appropriate marker to monitor the effects of anti-resorptive agens. Herein, we discuss monotherapy with vitamin D or bisphosphonates and concomitant use for GIO with CKD. We also discuss the usefulness of serum NTX, introducing the concept of a resorption index. |