Review article: Bone density in patients with chronic kidney disease stages 4-5
Article first published online: 12 MAY 2009
© 2009 The Author. Journal compilation © 2009 Asian Pacific Society of Nephrology
Special Issue: Special Issue on CKD-MBD, Guest Editor: Grahame Elder
Volume 14, Issue 4, pages 395–403, June 2009
How to Cite
OTT, S. M. (2009), Review article: Bone density in patients with chronic kidney disease stages 4-5. Nephrology, 14: 395–403. doi: 10.1111/j.1440-1797.2009.01159.x
- Issue published online: 22 JUN 2009
- Article first published online: 12 MAY 2009
- Accepted for publication 6 May 2009.
- bone density;
Skeletal fractures are common in dialysis patients. Bone density measurements predict fractures in the general population, but in patients with chronic kidney disease (CKD) there is limited ability to predict fractures with these techniques. A review of the literature in patients with CKD stage 5 shows that bone density in the cortical bone of the radius or hip is generally lower compared with normal reference ranges by about one to two standard deviations, whereas in the spine bone density tends to be closer to the average expected values. The bone density is not able to predict the underlying histology in patients with renal osteodystrophy. The serum PTH levels are inversely related to bone density in some studies, and not related in other studies, but none found a positive association of serum parathyroid hormone (PTH) and bone density. There are very few data about longitudinal changes of bone density in these patients, and also inadequate studies of whether osteoporosis medications are effective in this population. Therefore, at this time the clinical utility of bone density measurements in patients with CKD-5 is uncertain.