Osteoporosis in Chronic Kidney Disease

Abstract

Osteoporosis (OP) is defined as a systemic skeletal disease characterized by low mass and deterioration of bone tissue microarchitecture, with a consequent increased risk of fractures. OP is common and chronic kidney disease (CKD) is one of the main risk factors for its occurrence. CKD is associated with the complex mineral and bone disorders, named CKD-MBD, which is a syndrome characterized by biochemical, hormonal and bone metabolism disturbances. CKD patients, at all stages of the disease, are at increased risk of developing OP. However, in these patients, OP goes beyond its classic concept, since the factors related to CKD-MBD add to those found in the general population. As, until now, both the pathophysiology, the diagnosis and treatment of OP in CKD are not fully established, the need for a study that answers these questions is evident. The proposed project aims to obtain national data on the treatment of OP in patients with CKD, assess pathophysiological mechanisms, establish the value of the diagnostic methods and evaluate the efficacy and safety of treatment of OP with bisphosphonate in bone mass gain. The results of this study may impact the treatment of OP in this population, offering a level of evidence for the recommendations of national and international guidelines, currently based on opinion. Patients with CKD 2-4 from university outpatient clinics at USP and UNIFESP will participate in the study. This study comprises 11 subprojects, each one with its specific methodology, some observational and others with a prospective, double-blind design, randomized in the 1:1 ratio, with sodium alendronate and placebo. (AU)