Osteoporosis in renal failure: how accurate is the diagnosis and is there any role for bisphosphonates?

Patients with chronic renal failure [CRF] may be at a particularly increased risk for osteoporosis and its related fractures given the high prevalence of some of the known risk factors for osteoporosis. The challenge is how to accurately make the diagnosis of osteoporosis in subjects with CRF since low bone mineral density and fractures could result from secondary hyperparathyroidism, adynamic bone disease, osteomalacia, as well as osteoporosis. Helpful tests include bone turnover markers and double tetracycline-labeled bone biopsy. In patients with confirmed osteoporosis, preliminary data suggest that bisphosphonates seem to be safe and effective down to glomerular filtration rates of 15 mL/min. Low to moderate doses of vitamin D analogues are also helpful in such patients

Ibn'Sina rounds

We continue these excerpts from the case records of Dr Abubakr, current resident to that august, testy and infinitely wise consultant physician, Dr Ibn 'Sina The Ibn'Sina Rounds are presentations of actual clinical situations with a moral and teaching value

Ibn'Sina rounds

We continue these excerpts from the case records of Dr Abubakr, current resident to that august, testy and infinitely wise consultant physician, Dr Ibn 'Sina. The Ibn 'Sina Rounds are presentations of actual clinical situations with a moral and teaching value