Osteoporosis and Chronic Kidney Disease

Editor's Introduction

Osteoporosis, as defined by The National Institutes of Health Consensus Conference, may co-exist with renal bone disease or renal osteodystrophy - a histomorphometrically defined complex group of skeletal disorders caused by chronic kidney disease (CKD). Forms of osteodystrophy include severe hyperparathyroidism (or osteitis fibrosa cystica), adynamic bone disease, osteomalacia, and post-transplantation syndrome. Like osteoporosis, all forms of renal osteodystrophy can cause fragility fractures. The potential presence of one or more of these bone diseases makes treating renal-disease patients complex and difficult. How best to treat skeletal disease associated with renal insufficiency or failure is still a challenge despite all the therapies available for osteoporosis treatment. The lack of guidelines for drug use in these patients has long been an issue and remains so today. This issue of Osteoporosis: Clinical Updates brings into focus this clinical conundrum. It addresses many of the current questions about bone health and renal disease and updates present knowledge about pathology and therapy. -Angelo Licata, MD, PhD