Editorial: Management of osteoporosis in patients with chronic kidney disease

Abstract

Editorial on the Research Topic Management of osteoporosis in patients with chronic kidney diseaseChronic kidney disease (CKD) is a major health problem that has devastating metabolic and bone consequences. Osteoporosis is one of the pivotal metabolic disorders in patients with CKD which can increase the risk of fractures and mortality. Most nephrologists are familiar with management of CKD-Mineral and Bone Disorders (CKD-MBD), however, there is a big gap in diagnosis and management of osteoporosis. This special issue editorial is trying to focus on identifying the mechanisms behind bone loss that will help to precisely improve the outcome of patients with CKD.In terms of diagnostic tools, trabecular bone score (TBS) is an emerging analytical tool depends on the gray-level variations of lumbar vertebrae and can be applied to DEXA images to assess bone micro-architecture. Clinical importance of TBS has been proved in patients with osteoporosis. Though, its value in patients with end-stage kidney disease (ESKD) needs to be validated. Patients on maintenance dialysis had an altered bone microarchitecture, however, there are no prospective trials to evaluate TBS role in fracture prediction in ESKD. In this special issue, Poiana et al. reviewed the role of TBS in fracture risk assessment and management of CKD-MBD in dialysis patients. They concluded that TBS might add more information to DEXA measurements and improve the fracture risk assessment.Cardiovascular disease is one of the catastrophic complications in patients with CKD. Both traditional and non-traditional risk factors contribute in the development of cardiovascular calcification (VC) (1). Osteoprotegerin (OPG) impedes bone loss through