In patients with end-stage kidney failure (creatinine clearance <10 mL/minute, including patients receiving dialysis) because of higher risk for hypercalcemia after calcium and vitamin D administration and for hypocalcemia after denosumab administration, serum calcium, phosphorus, 25-hydroxyvitamin D, and parathyroid hormone levels should be measured after four months of calcium prescriptions and approximately 10 days after denosumab administration. In patients with estimated glomerular filtration rate <30 mL/minute and fragility fracture, if there is no evidence of metabolic bone disease, after initiation of osteoporosis therapy, measurement of bone mineral density at beginning and two years after later may be helpful for monitoring of response to therapy.
Implication for health policy/practice/research/ medical education
In chronic kidney disease, changes in calcium and phosphorus and vitamin D metabolism lead to derangement of bone structure and architecture and progress with worsening of kidney function and lead to osteoporosis and fractures.
Please cite this paper as: Moussavi MR. Osteoporosis in chronic kidney disease; a mini-review on current knowledge. J Parathyr Dis 2013; 1(1): 5-8.