With these 7 tips, kidney disease patients can easily cope with osteoporosis!

How is CKD osteoporosis treated?

1.
Regardless of whether there is a history of fracture, those diagnosed with osteoporosis (BMD T value≤-2.
5);

2.
Patients with more than 1 risk factor for osteoporosis and low bone mass (BMD -2.
5< T value≤-1.
0) regardless of whether there is a history of fracture;

3.
When BMD cannot be measured, those who have had fragility fractures, those with OSTA screening as high-risk, the FRAX tool calculates the probability of hip fracture ≥3%, and the
probability of osteoporotic fracture in any major part is ≥20%.

1.
Bisphosphonates

• CPatients with stages 1-2 KD who develop osteoporosis and/or high risk of fracture are recommended to use bisphosphonates according to the general population regimen;

  
  

• Bisphosphonate therapy in patients with stage CKD 3-4 is effective for osteoporosis, and there is no strong evidence that bisphosphonate treatment causes non-kinetic bone disease, resulting in abnormal biochemistry of CKM-MBD and low BMD and/ or fragility fractures, it is recommended to choose whether to add bisphosphonates or other osteoporotic drugs based on the magnitude and reversibility of biochemical changes and the progression of CKD, and consider bone biopsy;

  
  

• When treating with bisphosphonates in patients with stage CKD, special care should be taken to exclude non-motility bone disease
  based on biochemical indicators or bone biopsy.
  

2.
Calcium, active vitamin D and their analogues

• CKD stage 1-2 patients with osteoporosis and/or high risk of fracture, the method of use refers to the general population;

• In nondialysis patients with normal stage 3-5 iPTH and low BMD and/or high fracture risk, the recommended dose of active vitamin D is 0.
  25- 0.
  5micrograms/day orally once or in 2 divided doses;

• Active vitamins are recommended in patients with stage C KD stage 3-5 who have not received dialysis and have low BMD and/or a high risk of fracture and who have progressively elevated iPTH and remain above the upper limit of normal despite correction of modifiable factors D and its analogues were treated and the smallest starting dose was selected for intermittent or continuous administration, maintaining iPTH in the normal range;

• Patients on stage 5 CKD dialysis with low BMD and/or high risk of fracture should be selected for active/nutritional vitamin D based on iPTH levels and considered for bone biopsy
  .
  

3.
Calcitonin