Management of adynamic bone disease in chronic kidney disease: A brief review

摘要

Highlights ? CKD-MBD can lead to bone fragility, either with high bone turnover or low bone turnover. ? Adynamic bone disease is characterized by a low-bone-turnover state. ? Bone biopsy remains the diagnostic gold standard for adynamic bone disease. ? Aggressive PTH suppression can increase the risk of this disease process. ? Novel, anabolic agents may play a therapeutic role in ABD management. Abstract The Kidney Disease: Improving Global Outcomes (KDIGO) work group released recommendations in 2006 to define the bone-related pathology associated with chronic kidney disease as renal osteodystrophy. In 2009, KDIGO released revised clinical practice guidelines which redefined systemic disorders of bone and mineral metabolism due to chronic kidney disease as chronic kidney disease-mineral and bone disorders. Conditions under this overarching term include osteitis fibrosa cystica, osteomalacia, and adynamic bone disease. We aim to provide a brief review of the histopathology, pathophysiology, epidemiology, and diagnostic features of adynamic bone disease, focusing on current trends in the management of this complex bone disorder.