- 期刊
慢性腎臟疾病患者的骨質疏鬆症：診斷及治療
Osteoporosis in Chronic Kidney Disease Patient: Diagnosis and Treatment
摘要
隨著慢性腎臟疾病（chronic kidney disease, CKD）的惡化，骨折的發生率增加。因CKD導致礦物質與骨骼代謝異常的系統性疾病與骨質疏鬆症的治療不同，需要正確的診斷及區別來預防慢性腎臟病患的骨折風險。第1~3期CKD患者可用標準骨密度來診斷骨質疏鬆症，而在後期CKD骨代謝異常疾病更明顯，無法用骨密度診斷。血清生化標誌和／或定量骨組織形態測量可以區分骨質疏鬆症及腎性骨病變。第4和5期的CKD患者骨質疏鬆症的治療並非基於證據的。本篇文章回顧目前對CKD 1~5期的骨質疏鬆症診斷及治療。
並列摘要
The incidence of bone fractures increases with the progression of chronic kidney disease (CKD). Both traditional osteoporosis and chronic kidney disease-mineral bone disorders (CKD-MBD) may occur in these patients; it is clinically important to distinguish between these disorders to prevent fracture risk of chronic kidney patients. Although standard osteoporosis definition is applicable in stage 1 ~ 3 CKD patients, it is not relevant in late stages of CKD since metabolic bone disorders become more evident in these stages. Serum biochemical markers and/or quantitative bone histomorphometry can distinguish osteoporosis and renal osteodystrophy. Appropriateness of osteoporotic medications in late stages of CKD patients is still not clear recently. This article reviews the current concepts on diagnosis and management of osteoporosis among different stages of CKD.
延伸閱讀
- 蔡宛蓉、陳建良（2017）。慢性腎臟病患者骨病變的診斷與治療。腎臟與透析，29(4)，165-168。https://doi.org/10.6340/KD.2017.29(4).04
- 何韋德、陳薏如、黃錫培、何永和、劉文治、楊麗琼（2015）。慢性腎臟病之血管鈣化與治療。腎臟與透析，27(3)，129-134。https://doi.org/10.6340/KD.2015.27(3).07
- 何韋德、陳薏如、黃錫培、何永和、劉文治、楊麗琼（2018）。慢性腎臟病之血管鈣化與治療。載於社團法人台灣腎臟醫學會 、 Ainosco Press（主編），慢性腎臟病及其合併症：治療與照護手冊（頁245-250）。社團法人台灣腎臟醫學會；Ainosco Press。https://doi.org/10.6140/AP.9789864371389.ch_028
- 徐煜能、游棟閔、吳明儒（2018）。慢性腎臟病與骨病變。載於社團法人台灣腎臟醫學會 、 Ainosco Press（主編），慢性腎臟病及其合併症：治療與照護手冊（頁205-216）。社團法人台灣腎臟醫學會；Ainosco Press。https://doi.org/10.6140/AP.9789864371389.ch_023
- Cusano, N. E., Costa, A. G., Silva, B. C., & Bilezikian, J. P. (2011). Therapy of Osteoporosis in Men with Teriparatide. Journal of Osteoporosis, 2011(), 146-152. https://doi.org/10.4061/2011/463675