The various (many) guidelines were not designed with kidney disease in mind.\u00a0 Locally we have not used bisphosphonates very often in this group, tending to favour vitamin D preparations that are already in use.\u00a0 Two specific concerns are:<\/p>\n
For patients with normal or mildly impaired kidney function, the Lothian Joint Formulary Committee recommendation for patients receiving \u22657.5mg prednisolone or equivalent is:<\/p>\n
Risk factors for osteoporosis, or demonstration of osteoporosis will influence decisions.\u00a0 Note that bone density measurements are of unknown relevance in patients with renal failure, in whom osteodystrophy may confound interpretation.<\/p>\n
COMMENCE PROPHYLAXIS WHEN STEROID TREATMENT IS INITIATED<\/span><\/strong><\/p>\n Lothian Joint Formulary Guidance<\/p>\n <\/p>\n Acknowledgements:\u00a0<\/strong>\u00a0 Neil<\/span> Turner was the main author for this page. The last modified date is shown in the footer.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":" The various (many) guidelines were not designed with kidney disease in mind.\u00a0 Locally we have not used bisphosphonates very often in this group, tending to favour vitamin D preparations that are already in use.\u00a0 Two specific concerns are: Unknown effects of bisphosphonates on bone already suffering from renal osteodystrophy Calcium\u2026<\/p>\n\n\n
\n Risk Factors<\/span><\/strong>
\nMenopause <45 years
\nPersonal or family history of low-trauma fractures
\nAmenorrhoea
\nSlender build (BMI < 20kg\/m2)
\nImmobility<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nAlternative Treatments<\/span><\/strong><\/h5>\n
\n
More information<\/span><\/strong><\/h5>\n