RT Journal Article
T1 Control of phosphorus and prevention of fractures in the kidney patient.
T2 Control del fósforo y prevención de fracturas en el paciente renal.
A1 González-Parra, Emilio
A1 Bover, Jordi
A1 Herrero, Jose
A1 Sánchez, Emilio
A1 Molina, Pablo
A1 Martin-Malo, Alejandro
A1 Bajo Rubio, Maria Auxiladora
A1 Lloret, Susa
A1 Navarro, Juan
A1 Arenas, María Dolores
K1 Bone
K1 Enfermedad renal
K1 Fractura
K1 Fracture
K1 Fósforo
K1 Hueso
K1 Kidney disease
K1 Osteoporosis
K1 Phosphorus
AB Patients with chronic kidney disease have a higher risk of fractures than the general population due to the added factor of uraemia. Although the mechanisms behind uraemia-associated fractures are not fully understood, it is widely accepted that the decrease in bone mineral content and alteration in bone architecture both increase bone fragility. As chronic kidney disease progresses, the risk of fracture increases, especially once the patient requires dialysis. Among the many causes of the increased risk are advanced age, amenorrhoea, steroid exposure, decreased vitamin D, increased parathyroid hormone (PTH), malnutrition and chronic inflammation. Serum phosphorus, whether high or very low, seems to correlate with the risk of fracture. Moreover, increased serum phosphate is known to directly and indirectly affect bone metabolism through the development of adaptive hormonal mechanisms aimed at preventing hyperphosphataemia, such as the increase in PTH and fibroblast growth factor 23 (FGF23) and the reduction in calcitriol. These adaptive mechanisms are less intense if the intestinal absorption of phosphorus is reduced with the use of phosphorus captors, which seem to have a positive impact in reducing the risk of fractures. We describe here the possible mechanisms associating serum phosphorus levels, the adaptive mechanisms typical in kidney disease and the use of drugs to control hyperphosphataemia with the risk of fractures. We found no studies in the literature providing evidence on the influence of different treatments on the risk of fractures in patients with chronic kidney disease. We suggest that control of phosphorus should be an objective to consider.
YR 2020
FD 2020-09-25
LK http://hdl.handle.net/10668/16325
UL http://hdl.handle.net/10668/16325
LA en
LA es
DS RISalud
RD Apr 11, 2025