Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement
BackgroundManaging osteoporosis (OP) in chronic kidney disease (CKD) presents significant challenges due to altered bone metabolism. Given the lack of robust clinical trial data and a notable knowledge gap exists among nephrologists regarding an optimal management in this population, an expert conse...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Nephrology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneph.2025.1601610/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850116841231351808 |
|---|---|
| author | Vijay Kher Rajkumar Sharma Georgi Abraham Bharat Shah Sishir Gang Sanjeev Gulati Manisha Sahay Jatin Kothari Anil Kumar BT Raja Ramachandran Sanjay Kalra Rakesh Kumar Sahay Om Lakhani Jay Kumar Sharma Deepak Bunger Thomas L. Nickolas |
| author_facet | Vijay Kher Rajkumar Sharma Georgi Abraham Bharat Shah Sishir Gang Sanjeev Gulati Manisha Sahay Jatin Kothari Anil Kumar BT Raja Ramachandran Sanjay Kalra Rakesh Kumar Sahay Om Lakhani Jay Kumar Sharma Deepak Bunger Thomas L. Nickolas |
| author_sort | Vijay Kher |
| collection | DOAJ |
| description | BackgroundManaging osteoporosis (OP) in chronic kidney disease (CKD) presents significant challenges due to altered bone metabolism. Given the lack of robust clinical trial data and a notable knowledge gap exists among nephrologists regarding an optimal management in this population, an expert consensus is crucial for developing tailored management strategies. This study aimed to gather an expert opinion to bridge this gap and establish consensus recommendations on the diagnosis and management of osteoporosis in CKD patients.MethodsA panel of 13 Indian and 1 international experts, including nephrologists and endocrinologists, participated in a structured survey and discussion process. Thirteen Indian experts provided their opinion on key clinical issues, including screening, diagnosis, and treatment strategies for osteoporosis in CKD. Consensus was achieved in a single round of voting, and recommendations were formulated based on the level of agreement among the panelists.ResultsThe expert panel reached a strong consensus (80-100% agreement) on several critical recommendations. It was agreed that osteoporosis in CKD is often asymptomatic, with fragility fractures being less common, and thus, early screening using dual-energy X-ray absorptiometry (DXA) is essential. The panel emphasized the importance of evaluating bone turnover status using serum biomarkers such as bone-specific alkaline phosphatase (BSAP) and intact parathyroid hormone (iPTH) to guide treatment decisions. Tailored treatment strategies were recommended, with a judicious use of bisphosphonates and denosumab, depending on the patient’s estimated glomerular filtration rate (eGFR) and bone turnover state. The management of renal osteodystrophy (ROD) was deemed necessary before addressing CKD-induced osteoporosis.ConclusionThis expert consensus provides critical insights and guidance for the management of osteoporosis in CKD. The recommendations emphasize individualized treatment approaches, the importance of early screening, and the integration of multidisciplinary care. These findings aim to fill existing knowledge gaps and improve clinical outcomes for CKD patients with osteoporosis. |
| format | Article |
| id | doaj-art-392c9c8767e94b598857bf0f3eb6ae50 |
| institution | OA Journals |
| issn | 2813-0626 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nephrology |
| spelling | doaj-art-392c9c8767e94b598857bf0f3eb6ae502025-08-20T02:36:13ZengFrontiers Media S.A.Frontiers in Nephrology2813-06262025-07-01510.3389/fneph.2025.16016101601610Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statementVijay Kher0Rajkumar Sharma1Georgi Abraham2Bharat Shah3Sishir Gang4Sanjeev Gulati5Manisha Sahay6Jatin Kothari7Anil Kumar BT8Raja Ramachandran9Sanjay Kalra10Rakesh Kumar Sahay11Om Lakhani12Jay Kumar Sharma13Deepak Bunger14Thomas L. Nickolas15Department of Nephrology and Kidney Transplantation, Epitome Kidney Urology Institute and Lions Hospital, New Delhi, Delhi, IndiaDepartment of Nephrology and Renal Care, Medanta Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Nephrology, MGM Healthcare and Hospital, Chennai, Tamil Nadu, IndiaInstitute of Renal Sciences, Gleneagles Hospital, Mumbai, Maharashtra, IndiaDepartment of Nephrology, Muljibhai Patel Urological Hospital (MPUH), Nadiad, Gujarat, IndiaDepartment of Nephrology and Kidney Transplantation, Fortis Escorts Hospital, New Delhi, Delhi, IndiaDepartment of Nephrology, Osmania Medical College and Hospital, Hyderabad, Telangana, IndiaDepartment of Nephrology and Kidney Transplantation, Nanavati Max Super Speciality Hospital, Mumbai, Maharashtra, IndiaDepartment of Nephrology, Gleneagles BGS Hospital, Bengaluru, Karnataka, India0Department of Nephrology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India1Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India2Department of Endocrinology, Osmania Medical College and Hospital, Hyderabad, Telangana, India3Department of Endocrinology, Zydus Hospital, Ahmedabad, Gujarat, India4Department of Medical Affairs, Intas Pharmaceuticals Limited (Corporate Office), Ahmedabad, Gujarat, India4Department of Medical Affairs, Intas Pharmaceuticals Limited (Corporate Office), Ahmedabad, Gujarat, India5Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY, United StatesBackgroundManaging osteoporosis (OP) in chronic kidney disease (CKD) presents significant challenges due to altered bone metabolism. Given the lack of robust clinical trial data and a notable knowledge gap exists among nephrologists regarding an optimal management in this population, an expert consensus is crucial for developing tailored management strategies. This study aimed to gather an expert opinion to bridge this gap and establish consensus recommendations on the diagnosis and management of osteoporosis in CKD patients.MethodsA panel of 13 Indian and 1 international experts, including nephrologists and endocrinologists, participated in a structured survey and discussion process. Thirteen Indian experts provided their opinion on key clinical issues, including screening, diagnosis, and treatment strategies for osteoporosis in CKD. Consensus was achieved in a single round of voting, and recommendations were formulated based on the level of agreement among the panelists.ResultsThe expert panel reached a strong consensus (80-100% agreement) on several critical recommendations. It was agreed that osteoporosis in CKD is often asymptomatic, with fragility fractures being less common, and thus, early screening using dual-energy X-ray absorptiometry (DXA) is essential. The panel emphasized the importance of evaluating bone turnover status using serum biomarkers such as bone-specific alkaline phosphatase (BSAP) and intact parathyroid hormone (iPTH) to guide treatment decisions. Tailored treatment strategies were recommended, with a judicious use of bisphosphonates and denosumab, depending on the patient’s estimated glomerular filtration rate (eGFR) and bone turnover state. The management of renal osteodystrophy (ROD) was deemed necessary before addressing CKD-induced osteoporosis.ConclusionThis expert consensus provides critical insights and guidance for the management of osteoporosis in CKD. The recommendations emphasize individualized treatment approaches, the importance of early screening, and the integration of multidisciplinary care. These findings aim to fill existing knowledge gaps and improve clinical outcomes for CKD patients with osteoporosis.https://www.frontiersin.org/articles/10.3389/fneph.2025.1601610/fullosteoporosischronic kidney diseaseexpert consensusrenal osteodystrophymineral and bone disorderbone turnover markers |
| spellingShingle | Vijay Kher Rajkumar Sharma Georgi Abraham Bharat Shah Sishir Gang Sanjeev Gulati Manisha Sahay Jatin Kothari Anil Kumar BT Raja Ramachandran Sanjay Kalra Rakesh Kumar Sahay Om Lakhani Jay Kumar Sharma Deepak Bunger Thomas L. Nickolas Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement Frontiers in Nephrology osteoporosis chronic kidney disease expert consensus renal osteodystrophy mineral and bone disorder bone turnover markers |
| title | Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement |
| title_full | Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement |
| title_fullStr | Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement |
| title_full_unstemmed | Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement |
| title_short | Diagnosis, evaluation and management of osteoporosis in chronic kidney disease: navigating treatment approaches – Indian consensus statement |
| title_sort | diagnosis evaluation and management of osteoporosis in chronic kidney disease navigating treatment approaches indian consensus statement |
| topic | osteoporosis chronic kidney disease expert consensus renal osteodystrophy mineral and bone disorder bone turnover markers |
| url | https://www.frontiersin.org/articles/10.3389/fneph.2025.1601610/full |
| work_keys_str_mv | AT vijaykher diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT rajkumarsharma diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT georgiabraham diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT bharatshah diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT sishirgang diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT sanjeevgulati diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT manishasahay diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT jatinkothari diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT anilkumarbt diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT rajaramachandran diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT sanjaykalra diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT rakeshkumarsahay diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT omlakhani diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT jaykumarsharma diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT deepakbunger diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement AT thomaslnickolas diagnosisevaluationandmanagementofosteoporosisinchronickidneydiseasenavigatingtreatmentapproachesindianconsensusstatement |