ISSN 1849-9031 (Online)

ISSN 1849-8922    (Print)

Bone disease in elderly dialysis patients.
Draško Pavlović, Dajana Katičić, Josipa Josipović, Tonko Gulin.

Abstract


Bone disease is a well-known complication of chronic kidney disease. Bone fracture risk is increased in dialysis patients, particularly in the elderly. Secondary hyperparathyroidism is an important factor, but increased bone fragility can not only be explained by increased parathyroid gland activity. A new term, uremic or chronic kidney disease osteoporosis has been proposed. The diagnosis is not simple, and besides new densitometric methods, e.g. high resolution peripheral quantitative computed tomography (HR-pQCT), biochemical parameters and the adapted fracture risk assessment tool (FRAX) could be used. In addition to the classic treatment of renal osteodystrophy, new drugs like teriparatide or denosumab could be used. Unfortunately, randomized prospective studies of new drugs in dialysis patients are lacking. The incidence of bone fractures, diagnosis of osteoporosis, and treatment of osteoporosis in dialysis patients is briefly described in this short review.