Bone Quality in Chronic Kidney Disease Patients: Current Concepts and Future Directions-Part II

Kamyar Asadipooya, Mohamed Abdalbary, Yahya Ahmad, Elijah Kakani, Marie Claude Monier-Faugere, Amr El-Husseini

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Patients with chronic kidney disease (CKD) have an increased risk of osteoporotic fractures, which is due not only to low bone volume and mass but also poor microarchitecture and tissue quality. The pharmacological and nonpharmacological interventions detailed, herein, are potential approaches to improve bone health in CKD patients. Various medications build up bone mass but also affect bone tissue quality. Antiresorptive therapies strikingly reduce bone turnover; however, they can impair bone mineralization and negatively affect the ability to repair bone microdamage and cause an increase in bone brittleness. On the other hand, some osteoporosis therapies may cause a redistribution of bone structure that may improve bone strength without noticeable effect on BMD. This may explain why some drugs can affect fracture risk disproportionately to changes in BMD. Summary: An accurate detection of the underlying bone abnormalities in CKD patients, including bone quantity and quality abnormalities, helps in institution of appropriate management strategies. Here in this part II, we are focusing on advancements in bone therapeutics that are anticipated to improve bone health and decrease mortality in CKD patients. Key Messages: Therapeutic interventions to improve bone health can potentially advance life span. Emphasis should be given to the impact of various therapeutic interventions on bone quality.

Original languageEnglish
Pages (from-to)359-371
Number of pages13
JournalKidney Diseases
Volume7
Issue number5
DOIs
StatePublished - Sep 1 2021

Bibliographical note

Publisher Copyright:
© 2021

Keywords

  • Bone mineral density
  • Bone quality
  • Chronic kidney disease
  • Management

ASJC Scopus subject areas

  • Nephrology

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