慢性腎臟病患的骨質疏鬆症治療

Therapeutic Approach to Osteoporosis in Patients with Chronic Kidney Disease

施得恩(Te-En Shih) ； 吳至行(Chih-Hsing Wu) ； 楊倫欣(Lun-Hsin Yang) ； 王明誠(Ming-Cheng Wang)

《內科學誌》 20卷6期 (2009/12) Pp. 514-523

https://doi.org/10.6314/JIMT.2009.20(6).06

摘要

骨質疏鬆症(osteoporosis)是一種造成骨骼強度減低的骨骼疾病。慢性腎臟病(chronic kidney disease, CKD)則因腎功能降低導致礦物質與骨骼代謝異常使得骨骼代謝轉換(bone turnover)、礦物化(mineralization)及骨量(volume)有複雜的變化及異常的系統性疾病(CKD-mineral and bone disorders, CKD-MBD)。慢性腎臟病患比一般人更易有骨質疏鬆症。當骨質疏鬆症及慢性腎臟病導致礦物質與骨骼代謝異常的系統性疾病同時存在時，則骨折的危險性會增加，其相關的併發症及死亡率也增加。對於慢性腎臟病患的骨質疏鬆症藥物治療仍未有足夠的研究證實其治療的效果及安全性。本篇文章主要回顧目前對慢性腎臟病患骨質疏鬆症的治療。

關鍵字

骨質疏鬆症 ； 慢性腎臟病 ； 雙磷酸鹽類 ； 副甲狀腺素 ； 選擇性雌激素接受器調節劑

並列摘要

Osteoporosis is a skeletal disease characterized by decreased bone strength. Patients with chronic kidney disease (CKD) have disturbances in bone and mineral metabolism leading to complex changes in bone turnover, mineralization and volume, which has been defined as chronic kidney disease-mineral and bone disorder (CKDMBD) recently. Patients with CKD may have higher prevalence of osteoporosis compared to general population. The coexistence of osteoporosis and CKD-MBD seems to be related to increased fracture risk, leading to increased morbidity and mortality. There is little information about the appropriate pharmacological therapy for osteoporosis in patients with CKD, including the beneficial effect and the safety. This article reviews the current therapeutic approach to osteoporosis in patients with CKD.

並列關鍵字

Osteoporosis ； Chronic kidney disease ； Bisphosphonate ； Parathyroid hormone ； Selective estrogen receptor modulator