Differentiating the causes of adynamic bone in advanced chronic kidney disease informs osteoporosis treatment

Patients with chronic kidney disease (CKD) have an increased fracture risk because of impaired bone quality and quantity. Low mineral density predicts in all CKD stages, including advanced (CKD G4-5D). Pharmacological therapy improves reduces moderate CKD. Its efficacy remains to be determined, although pilot studies suggest a positive effect on density. Currently, antiresorptive agents are the most commonly prescribed drugs for prevention osteoporosis. Their use has been limited by lack large clinical trials fear causing dysfunction adynamic disease. In recent decades, evolved as predominant form renal osteodystrophy, associated poor outcomes, premature mortality progression vascular calcification. Evolving evidence indicates that reduction turnover parathyroidectomy or pharmacological therapies, such calcimimetics agents, not accelerated calcification contrast, inflammation, oxidative stress, malnutrition, diabetes can induce low associate prognosis. 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