Dietary Protein Intake and Bone Across Stages of Chronic Kidney Disease
AbstractPurpose of ReviewThis review aims to summarize the current evidence on the effect of very-low-, low-, and high-protein diets on outcomes related to chronic kidney disease-mineral and bone disorder (CKD-MBD) and bone health in patients with CKD.Recent FindingsDietary protein restriction in the form of low- and very-low-protein diets have been used to slow down the progression of CKD. These diets can be supplemented with alpha-keto acid (KA) analogues of amino acids. Observational and randomized controlled trials have shown improvements in biochemical markers of CKD-MBD, including reductions in phosphorus, parathyroi...
Source: Current Osteoporosis Reports - April 1, 2020 Category: Orthopaedics Source Type: research
Developing Registries and Effective Care Models for the Management of Hip Fractures: Aligning Political, Organizational Drivers with Clinical Outcomes
AbstractPurpose of ReviewThe aim of the review is to conduct a literature search on cost-effectiveness or cost savings of osteoporosis fracture liaison services.Recent FindingsWe identified four types of FLS. A total of 11 cost-effectiveness studies examining 15 models of secondary fracture prevention models were identified. Nine models were found to be cost-saving, and five were found to be cost-effective.SummaryIt is possible to adopt a cost-effective model for fracture liaison services and expand across geographical regions. Adopting registries can have the added benefit of monitoring quality improvement practices and t...
Source: Current Osteoporosis Reports - April 1, 2020 Category: Orthopaedics Source Type: research
Management of Pain Associated with Fractures
AbstractPurpose of ReviewThe purpose is to review current literature on pain management strategies from initial presentation to postoperative care on common fracture types.Recent Findings- Hip fractures benefit from use of multimodal pain control for early mobility and decreased narcotic requirement.- Distal radius fracture pain during reduction can be managed with hematoma block. Postoperatively, a soft dressing is adequate, and use of a compression glove may improve pain control and edema.- Ankle fractures can be reduced with hematoma block, though use of procedural sedation may reduce reduction attempts for fracture dis...
Source: Current Osteoporosis Reports - March 30, 2020 Category: Orthopaedics Source Type: research
Effects of PTH and PTH Hypersecretion on Bone: a Clinical Perspective
AbstractPurpose of ReviewHyperparathyroidism may be due to an autonomous hypersecretion of parathyroid hormone (PTH) or occurs in response to a number of physiological stimuli. A number of recent findings have provided new insights into the importance of the calcium-parathyroid-vitamin D axis to bone in normal physiology and pathological conditions.Recent FindingsPTH is known to affect bone microarchitecture with different effects on cortical and trabecular bone compartments. In trabecular bone, PTH may exert anabolic effects, whereas PTH promotes bone resorption in cortical bone. Vertebral fractures are prevalent in prima...
Source: Current Osteoporosis Reports - March 27, 2020 Category: Orthopaedics Source Type: research
Transcriptomics: a Solution for Renal Osteodystrophy?
AbstractPurpose of ReviewThe molecular mechanisms of the bone disease associated with chronic kidney disease (CKD), called renal osteodystrophy (ROD), are poorly understood. New transcriptomics technologies may provide clinically relevant insights into the pathogenesis of ROD. This review summarizes current progress and limitations in the study and treatment of ROD, and in transcriptomics analyses of skeletal tissues.Recent FindingsROD is characterized by poor bone quality and strength leading to increased risk of fracture. Recent studies indicate permanent alterations in bone cell populations during ROD. Single-cell trans...
Source: Current Osteoporosis Reports - March 27, 2020 Category: Orthopaedics Source Type: research
