Prescription Patterns of Osteoporosis Medications in Patients With Advanced CKD: A Retrospective Cohort Study

Portales‐Castillo, Ignacio; Aksu, Cagri; Zhao, Sophia; Strohbehn, Ian A.; Sise, Meghan E.; Yu, Elaine W.; Nigwekar, Sagar U.

doi:10.1016/j.xkme.2021.07.005

Cited by 1 publication

(1 citation statement)

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“…For this reason, it is interesting to compare the results of this study with the observation by Portales-Castillo et al . [ 39 ], who analysed the prescriptive patterns of osteoporosis medications in CKD stages 2–5 patients who were diagnosed as osteoporotic by dual-energy X-ray absorptiometry scan. The average attention of the nephrologist to the specific aspect of bone disease is thus described.…”

Section: How To Address Shpt In Nd-ckd In Clinical Practicementioning

confidence: 99%

Treatment of secondary hyperparathyroidism in non-dialysis CKD: an appraisal 2022s

Ketteler

Bover

Mazzaferro

2022

Nephrology Dialysis Transplantation

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The situation of secondary hyperparathyroidism (sHPT) in CKD patients not on dialysis (ND-CKD) is probably best characterised by the KDIGO CKD-MBD Update 2017 guideline 4.2.1 stating that the optimal PTH levels is not known in these stages. Furthermore, new caution became recommended with regard to the routine use of active vitamin D analogues in early CKD stages and moderate sHPT phenotypes, due to their potential risks for hypercalcaemia and hyperphosphataemia aggravation. Nevertheless, there is still a substantial clinical need to prevent the development of parathyroid gland autonomy with its associated consequences of bone and vascular damage including fracture risks and cardiovascular events. Therefore, we now attempt to review the current guideline-based and clinical practice management of sHPT in ND-CKD including their strengths and weaknesses, favouring individualised approaches respecting calcium and phosphate homeostasis. We further comment on extended-release calcifediol (ERC) as a new differential therapeutic option now also available in Europe, and on a potentially novel understanding of a required vitamin D saturation in more advanced CKD stages. There is no doubt, however, that knowledge gaps will remain in this issue unless powerful RCTs with hard and meaningful endpoints are performed.

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Section: How To Address Shpt In Nd-ckd In Clinical Practicementioning

confidence: 99%