Osteoporosis, bone mineral density and CKD–MBD: treatment considerations

Jordi Bover1, Lucía Bailone1, Víctor López-Báez1, Silvia Benito1, Paola Ciceri2, Andrea Galassi2, Mario Cozzolino2
1Fundació Puigvert, Department of Nephrology, IIB Sant Pau, Barcelona, Spain
2Laboratory of Experimental Nephrology, Renal Division,San Paolo Hospital, DiSS University of Milan, Milan, Italy

Tóm tắt

Từ khóa


Tài liệu tham khảo

Reginster J-Y, Burlet N (2006) Osteoporosis: a still increasing prevalence. Bone 38(2):4–9. doi: 10.1016/j.bone.2005.11.024

Prevention NIH (2001) Consensus development panel on osteoporosis prevention, diagnosis, and therapy. JAMA 285(6):785–795. 10.1001/jama.285.6.785

Black DM, Rosen CJ (2016) Postmenopausal Osteoporosis. N Engl J Med (Table 1):595–603. doi: 10.1056/NEJMcp1513724

Unnanuntana A (2010) The assessment of fracture risk. J Bone Jt Surg 92(3):743. doi: 10.2106/JBJS.I.00919

Llach F, Bover J, Brenner BM (eds) (2000) The kidney, 6th edn. WB Sanders Company, ed., Philadelphia

Moe S, Drüeke T, Cunningham J et al (2006) Definition, evaluation, and classification of renal osteodystrophy: a position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int 69(11):1945–1953. doi: 10.1038/sj.ki.5000414

Goldenstein PT, Jamal SA, Moyses RM (2015) Fractures in chronic kidney disease: pursuing the best screening and management. Curr Opin Nephrol Hypertens 24(4):317–323. doi: 10.1097/MNH.0000000000000131

Maravic M, Ostertag A, Torres PU, Cohen-Solal M (2014) Incidence and risk factors for hip fractures in dialysis patients. Osteoporos Int 25(1):159–165. doi: 10.1007/s00198-013-2435-1

Jadoul M, Albert JM, Akiba T et al (2006) Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the dialysis outcomes and practice patterns study. Kidney Int 70(7):1358–1366. doi: 10.1038/sj.ki.5001754

Tentori F, Mccullough K, Kilpatrick RD et al (2014) High rates of death and hospitalization follow bone fracture among hemodialysis patients. Kidney Int 85(1):166–173. doi: 10.1038/ki.2013.279.High

Nickolas TL, McMahon DJ, Shane E (2006) Relationship between moderate to severe kidney disease and hip fracture in the United States. J Am Soc Nephrol 17(11):3223–3232. doi: 10.1681/ASN.2005111194

Naylor KL, Garg AX, Zou G et al (2015) Comparison of fracture risk prediction among individuals with reduced and normal kidney function. Clin J Am Soc Nephrol 10(4):646–653. doi: 10.2215/CJN.06040614

Kazama JJ, Iwasaki Y, Fukagawa M (2013) Uremic osteoporosis. Kidney Int Suppl 3(5):446–450. doi: 10.1038/kisup.2013.93

Dennison E, Mohamed MA, Cooper C (2006) Epidemiology of osteoporosis. Rheum Dis Clin North Am 32(4):617–629. doi: 10.1016/j.rdc.2006.08.003

Kanis JA, Borgstrom F, De Laet C et al (2005) Assessment of fracture risk. Osteoporos Int 16(6):581–589. doi: 10.1007/s00198-004-1780-5

Genant HK, Li J, Wu CY, Shepherd JA (2000) Vertebral fractures in osteoporosis 3(3):281–290

Cannata-Andía JB, Rodriguez García M, Gómez Alonso C (2013) Osteoporosis and adynamic bone in chronic kidney disease. J Nephrol 26(1):73–80. doi: 10.5301/jn.5000212

Diacinti D, Guglielmi G (2010) Vertebral morphometry. Radiol Clin North Am 48(3):561–575. doi: 10.1016/j.rcl.2010.02.018

Antonelli M, Einstadter D, Magrey M (2014) Screening and treatment of osteoporosis after hip fracture: comparison of sex and race. J Clin Densitom 17(4):479–483. doi: 10.1016/j.jocd.2014.01.009

Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20(10):1633–1650. doi: 10.1007/s00198-009-0920-3

Brandenburg VM, D’Haese P, Deck A et al (2016) From skeletal to cardiovascular disease in 12 steps—the evolution of sclerostin as a major player in CKD–MBD. Pediatr Nephrol 31(2):195–206. doi: 10.1007/s00467-015-3069-7

Zhang Y, Feng B (2016) Systematic review and meta-analysis for the association of bone mineral density and osteoporosis/osteopenia with vascular calcification in women. Int J Rheum Dis. doi: 10.1111/1756-185X.12842

Torregrosa J-V, Bover J, Cannata Andia J et al (2011) Spanish Society of Nephrology recommendations for controlling mineral and bone disorder in chronic kidney disease patients (S.E.N.-M.B.D.). Nefrologia 31(Suppl 1):3–32. doi: 10.3265/Nefrologia.pre2011.Jan.10816

Kidney Disease: Improving Global Outcomes (KDIGO) (2009) KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD–MBD). Off J Int Soc Nephrol Kidney Int 76

Gorriz JL, Molina P, Cerveron MJ et al (2015) Vascular calcification in patients with nondialysis CKD over 3 years. Clin J Am Soc Nephrol 10(4):654–666. doi: 10.2215/CJN.07450714

Bover J, Evenepoel P, Ureña-Torres P et al (2015) Opponent’s comments. Nephrol Dial Transpl 30(3):357. doi: 10.1093/ndt/gfv021a

Torres PU, Bover J, Mazzaferro S, de Vernejoul MC, Cohen-Solal M (2017) When, how, and why a bone biopsy should be performed in patients with chronic kidney disease. Semin Nephrol 34(6):612–625. doi: 10.1016/j.semnephrol.2014.09.004

KDIGO (2009) KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD–MBD). Kidney Int Suppl. 113:S1–130. doi: 10.1038/ki.2009.188

Cozzolino M, Urena-Torres P, Vervloet MG et al (2014) Is chronic kidney disease-mineral bone disorder (CKD–MBD) really a syndrome? Nephrol Dial Transpl 29(10):1815–1820. doi: 10.1093/ndt/gft514

West SL, Lok CE, Langsetmo L et al (2015) Bone mineral density predicts fractures in chronic kidney disease. J Bone Miner Res 30(5):913–919. doi: 10.1002/jbmr.2406

Yenchek RH, Ix JH, Shlipak MG et al (2012) Bone mineral density and fracture risk in older individuals with CKD. Clin J Am Soc Nephrol 7(7):1130–1136. doi: 10.2215/CJN.12871211

Iimori S, Mori Y, Akita W et al (2012) Diagnostic usefulness of bone mineral density and biochemical markers of bone turnover in predicting fracture in CKD stage 5D patients-a single-center cohort study. Nephrol Dial Transpl 27(1):345–351. doi: 10.1093/ndt/gfr317

Aucella F, Brunori G, Dalmartello M et al (2016) Assessment of the geriatric competence and perceived needs of Italian nephrologists: an internet survey. J Nephrol 29(3):385–390. doi: 10.1007/s40620-015-0232-y

Cosman F, de Beur SJ, LeBoff MS et al (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25(10):2359–2381. doi: 10.1007/s00198-014-2794-2

Bolland MJ, Avenell A, Baron JA et al (2010) Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691. doi: 10.1136/bmj.c3691

Bauer DC (2013) calcium supplements and fracture prevention. N Engl J Med 369(16):1537–1543. doi: 10.1056/NEJMcp1210380

Levey AS, Coresh J (2012) Chronic kidney disease. Lancet 379(9811):165–180. doi: 10.1016/S0140-6736(11)60178-5

Eckardt K-U, Coresh J, Devuyst O et al (2013) Evolving importance of kidney disease: from subspecialty to global health burden. Lancet 382(9887):158–169. doi: 10.1016/S0140-6736(13)60439-0

Chronic kidney disease (2014) Refi ning diagnosis and management Polio eradication: placing health before conflict. Lancet 384(9941):378. doi: 10.1016/S0140-6736(14)61267-8

Hill KM, Martin BR, Wastney ME et al (2013) Oral calcium carbonate affects calcium but not phosphorus balance in stage 3–4 chronic kidney disease. Kidney Int 83(5):959–966. doi: 10.1038/ki.2012.403

Spiegel DM, Brady K (2012) Calcium balance in normal individuals and in patients with chronic kidney disease on low- and high-calcium diets. Kidney Int 81(11):1116–1122. doi: 10.1038/ki.2011.490

Jr D, La Z, Margery G et al (2006) Calcium plus Vitamin D supplementation and the risk of fractures. N Engl J Med 354(7):669–683. doi: 10.1056/NEJMoa055218

Agarwal R, Georgianos PI (2016) Con: nutritional vitamin D replacement in chronic kidney disease and end-stage renal disease. Polar views in nephrology. JAMA 706–713. doi: 10.1093/ndt/gfw080

Anker SD, von Haehling S (2012) Vitamin D in chronic kidney disease. JAMA 307(7):722. doi: 10.1001/jama.2012.159

Goldsmith DJA (2016) Pro: should we correct vitamin D deficiency/insufficiency in chronic kidney disease patients with inactive forms of vitamin D or just treat them with active vitamin D forms?: Table 1. Nephrol Dial Transpl 31(5):698–705. doi: 10.1093/ndt/gfw082

LeBlanc ES, Zakher B, Daeges M, Pappas M, Chou R (2015) Screening for vitamin D deficiency: a systematic review for the U.S. preventive services task force. Ann Intern Med 162(2):109. doi: 10.7326/M14-1659

Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ et al (2016) Monthly high-dose vitamin D treatment for the prevention of functional decline. JAMA Intern Med 176(2):175. doi: 10.1001/jamainternmed.2015.7148

Bischoff-Ferrari HA, Willett WC, Orav EJ et al (2012) A pooled analysis of vitamin D Dose requirements for fracture prevention. N Engl J Med 367(1):40–49. doi: 10.1056/NEJMoa1109617

Mac-Way F, Azzouz L, Noel C, Lafage-Proust M-H (2014) Osteomalacia induced by vitamin D deficiency in hemodialysis patients: the crucial role of vitamin D correction. J Bone Miner Metab 32(2):215–219. doi: 10.1007/s00774-013-0480-7

Hernandez JD, Wesseling K, Boechat MI, Gales B, Salusky IB (2007) Osteomalacia in a hemodialysis patient receiving an active vitamin D sterol. Nat Clin Pract Nephrol 3(4):227–232. doi: 10.1038/ncpneph0443

Drake MT, Clarke BL, Khosla S (2008) Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc 83(9):1032–1045. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667901/

Festuccia F, Jafari MT, Fofi C et al (2017) Safety and efficacy of denosumab in osteoporotic hemodialysed patients. J Nephrol 30(2):271–279. doi: 10.1007/s00198-007-0540-8

Toussaint ND, Elder GJ, Kerr PG (2009) Bisphosphonates in chronic kidney disease; balancing potential benefits and adverse effects on bone and soft tissue. Clin J Am Soc Nephrol 4(1):221–233. doi: 10.2215/CJN.02550508

Bellido T, Plotkin LI (2011) Novel actions of bisphosphonates in bone: preservation of osteoblast and osteocyte viability. Bone 49(1):50–55. doi: 10.1016/j.bone.2010.08.008

Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24(1):23–57. doi: 10.1007/s00198-012-2074-y

Compston J, Bowring C, Cooper A et al (2013) Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas 75(4):392–396. doi: 10.1016/j.maturitas.2013.05.013

Diab DL, Watts NB (2013) Bisphosphonate drug holiday: who, when and how long. Ther Adv Musculoskelet Dis 5(3):107–111. doi: 10.1177/1759720X13477714

Sigua-Rodriguez EA, da Costa Ribeiro R, de Brito ACR, Alvarez-Pinzon N, de Albergaria-Barbosa JR (2014) Bisphosphonate-related osteonecrosis of the jaw: a review of the literature. Int J Dent 2014:192320. doi: 10.1155/2014/192320

Hellstein JW, Adler RA, Edwards B et al (2011) Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis. J Am Dent Assoc 142(11):1243–1251. doi: 10.14219/jada.archive.2011.0108

Khan AA, Morrison A, Hanley DA et al (2015) Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 30(1):3–23. doi: 10.1002/jbmr.2405

Burr DB, Miller L, Grynpas M et al (2003) Tissue mineralization is increased following 1-year treatment with high doses of bisphosphonates in dogs. Bone 33(6):960–969

Chapurlat RD, Arlot M, Burt-Pichat B et al (2007) Microcrack frequency and bone remodeling in postmenopausal osteoporotic women on long-term bisphosphonates: a bone biopsy study. J Bone Miner Res 22(10):1502–1509

Boivin GY, Chavassieux PM, Santora AC, Yates J, Meunier PJ (2000) Alendronate increases bone strength by increasing the mean degree of mineralization of bone tissue in osteoporotic women. Bone 27(5):687–694

Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CYC (2005) Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab 90(3):1294–1301

Armamento-Villareal R, Napoli N, Panwar V, Novack D (2006) Suppressed bone turnover during alendronate therapy for high-turnover osteoporosis. N Engl J Med 355(19):2048–2050

Ma S, Goh EL, Jin A et al (2017) Long-term effects of bisphosphonate therapy: perforations, microcracks and mechanical properties. Nat Publ Gr (November 2016) 1–10. doi: 10.1038/srep43399

Saita Y, Ishijima M, Kaneko K (2015) Atypical femoral fractures and bisphosphonate use: current evidence and clinical implications. Ther Adv Chronic Dis 6(4):185–193. doi: 10.1177/2040622315584114

Black DM, Kelly MP, Genant HK, Palermo L, Eastell R, Bucci-Rechtweg C, Cauley J, Leung PC, Boonen S, Santora A, de Papp A, Bauer DC, For the FIT, Committees and HPFTS (2010) Bisphosphonates and fractures of the subtrochanteric or diaphyseal femur. N Engl J Med 309:1761–1771. doi: 10.1056/NEJMoa0904327

Black DM, Schwartz AV, Ensrud KE et al (2006) Effects of continuing or stopping alendronate after 5 years of treatment: The fracture intervention trial long-term extension (flex): a randomized trial. JAMA 296(24):2927–2938. doi: 10.1001/jama.296.24.2927

Bone HG (2004) Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 350:1189–1199. 10.1056/NEJMoa030897

Whitaker M, Guo J, Ph D, Kehoe T, Benson G (2012) Bisphosphonates for osteoporosis—where do we go. N Engl J Med

Amerling R, Harbord NB, Pullman J, Feinfeld DA (2010) Bisphosphonate use in chronic kidney disease: association with adynamic bone disease in a bone histology series. Blood Purif 29(3):293–299. doi: 10.1159/000276666

Bover J, Urena P, Brandenburg V et al (2014) Adynamic bone disease: from bone to vessels in chronic kidney disease. Semin Nephrol 34(6):626–640. doi: 10.1016/j.semnephrol.2014.09.008

Brandenburg VM, Floege J (2008) Adynamic bone disease—bone and beyond. NDT Plus 1(3):135–147. doi: 10.1093/ndtplus/sfn040

Evenepoel P, Bover J, Ureña Torres P (2016) Parathyroid hormone metabolism and signaling in health and chronic kidney disease. Kidney Int 90(6):1184–1190. doi: 10.1016/j.kint.2016.06.041

Ketteler M, Elder GJ, Evenepoel P et al (2015) Revisiting KDIGO clinical practice guideline on chronic kidney disease-mineral and bone disorder: a commentary from a Kidney Disease: improving global outcomes controversies conference. Kidney Int 87(3):502–528. doi: 10.1038/ki.2014.425

Jamal SA, Bauer DC, Ensrud KE et al (2007) Alendronate treatment in women with normal to severely impaired renal function: an analysis of the fracture intervention trial. J Bone Miner Res 22(4):503–508. doi: 10.1359/jbmr.070112

Miller PD, Roux C, Boonen S et al (2005) Safety and efficacy of risedronate in patients with age-related reduced renal function as estimated by the cockcroft and gault method: a pooled analysis of nine. Clin Trials 20(12). doi: 10.1359/JBMR.050817

Toussaint ND, Lau KK, Strauss BJ, Polkinghorne KR, Kerr PG (2010) Effect of alendronate on vascular calcification in CKD stages 3 and 4: a pilot randomized controlled trial. Am J Kidney Dis 56(1):57–68. doi: 10.1053/j.ajkd.2009.12.039

Lomashvili KA, Monier-Faugere MC, Wang X, Malluche HH, O’Neill WC (2009) Effect of bisphosphonates on vascular calcification and bone metabolism in experimental renal failure. Kidney Int 75(6):617–625. doi: 10.1038/ki.2008.646

Beaudoin C, Jean S, Bessette L, Ste-Marie L-G, Moore L, Brown JP (2016) Denosumab compared to other treatments to prevent or treat osteoporosis in individuals at risk of fracture: a systematic review and meta-analysis. Osteoporos Int 27(9):2835–2844. doi: 10.1007/s00198-016-3607-6

Samelson EJ, Miller PD, Christiansen C et al (2014) RANKL inhibition with denosumab does not influence 3-year progression of aortic calcification or incidence of adverse cardiovascular events in postmenopausal women with osteoporosis and high cardiovascular risk. J Bone Miner Res 29(2):450–457. doi: 10.1002/jbmr.2043

Jamal SA, Ljunggren Ö, Stehman-Breen C et al (2011) Effects of denosumab on fracture and bone mineral density by level of kidney function. J Bone Miner Res 26(8):1829–1835. doi: 10.1002/jbmr.403

Aapro M, De Castro G, Cohen E, Deray G, Dooley M (2015) Renal effects of molecular targeted therapies in oncology: a review by the cancer and the kidney. 252–255. doi: 10.1093/annonc/mdv136

Block GA, Bone HG, Fang L, Lee E, Padhi D (2012) A single-dose study of denosumab in patients with various degrees of renal impairment. J Bone Miner Res 27(7):1471–1479. doi: 10.1002/jbmr.1613

Farinola N, Kanjanapan Y (2013) Denosumab-induced hypocalcaemia in high bone turnover states of malignancy and secondary hyperparathyroidism from renal failure. Intern Med J 43(11):1243–1246. doi: 10.1111/imj.12283

Dave V, Chiang CY, Booth J, Mount PF (2015) Hypocalcemia post denosumab in patients with chronic kidney disease stage 4–5. Am J Nephrol 41(2):129–137. http://www.karger.com/DOI/10.1159/000380960

Lambe G, Malvathu R, Thomas HM, Graves A (2015) Hypocalcaemic tetany occurring post a single denosumab dose in a patient with stage 4 chronic kidney disease, followed by calcium- and calcitriol-induced hypercalcaemia. Nephrology 20(8):583–584. doi: 10.1111/nep.12432

Hamano T, Nakano C (2016) Is denosmab really effective and safe in the care of CKD–MBD? Clin Calcium 26(9):1309

Miller PD, Schwartz EN, Chen P, Misurski DA, Krege JH (2007) Teriparatide in postmenopausal women with osteoporosis and mild or moderate renal impairment. Osteoporos Int 18(1):59–68. doi: 10.1007/s00198-006-0189-8

Schena FP, Ayasreh N, Fernandez-Llama P et al (2013) Recombinant PTH associated with hypercalcaemia and renal failure. Clin Kidney J 6(1):93–95. doi: 10.1093/ckj/sfs148

Leder BZ, Tsai JN, Jiang LA, Lee H (2017) Importance of prompt antiresorptive therapy in postmenopausal women discontinuing teriparatide or denosumab: the Denosumab and teriparatide follow-up study (DATA-follow-up). Bone 98:54–58. doi: 10.1016/j.bone.2017.03.006

Watts NB, Aggers D, McCarthy EF et al (2017) Responses to treatment with teriparatide in patients with atypical femur fractures previously treated with bisphosphonates. J Bone Miner Res. doi: 10.1002/jbmr.3081

Nishikawa A, Yoshiki F, Taketsuna M, Kajimoto K, Enomoto H (2016) Safety and effectiveness of daily teriparatide for osteoporosis in patients with severe stages of chronic kidney disease: post hoc analysis of a postmarketing observational study. Clin Interv Aging 11:1653–1659. doi: 10.2147/CIA.S120175

Giamalis P, Economidou D, Dimitriadis C, Memmos D, Papagianni A, Efstratiadis G (2015) Treatment of adynamic bone disease in a haemodialysis patient with teriparatide. Clin Kidney J 8(2):188–190. doi: 10.1093/ckj/sfv005

Cejka D, Kodras K, Bader T, Haas M (2010) Treatment of hemodialysis-associated adynamic bone disease with teriparatide (PTH1-34): a pilot study. Kidney Blood Press Res 33(3):221–226. doi: 10.1159/000316708

Miller PD, Hattersley G, Riis BJ et al (2016) Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial. JAMA 316(7):722–733. doi: 10.1001/jama.2016.11136

McClung MR, Grauer A, Boonen S et al (2014) Romosozumab in postmenopausal women with low bone mineral density. N Engl J Med 370(5):140101140147009. doi: 10.1056/NEJMoa1305224

Cosman F, Crittenden DB, Adachi JD et al (2016) Romosozumab treatment in postmenopausal women with osteoporosis. N Engl J Med 375(16):1532–1543. doi: 10.1056/NEJMoa1607948

Bandeira L, Lewiecki EM, Bilezikian JP (2017) Romosozumab for the treatment of osteoporosis. Expert Opin Biol Ther 17(2):255–263. doi: 10.1080/14712598.2017.1280455

McClung MR (2017) Clinical utility of anti-sclerostin antibodies. Bone. doi: 10.1016/j.bone.2016.12.012

Moe SM, Chen NX, Newman CL et al (2015) Anti—sclerostin antibody treatment in a rat model of progressive renal osteodystrophy. J Bone Miner Res 30(3):499–509. doi: 10.1002/jbmr.2372

Eastell R (2005) Role of oestrogen in the regulation of bone turnover at the menarche. J Endocrinol 185(2):223–234. doi: 10.1677/joe.1.06059

Anantharaman P, Schmidt RJ (2007) Sexual function in chronic kidney disease. Adv Chronic Kidney Dis 14(2):119–125. doi: 10.1053/j.ackd.2007.01.002

Haghverdi F, Farbodara T, Mortaji S, Soltani P, Saidi N (2014) Effect of raloxifene on parathyroid hormone in osteopenic and osteoporotic postmenopausal women with chronic kidney disease stage 5. Iran J Kidney Dis 8(6):461–466

Hernández E, Valera R, Alonzo E et al (2003) Effects of raloxifene on bone metabolism and serum lipids in postmenopausal women on chronic hemodialysis. Kidney Int 63(6):2269–2274. doi: 10.1046/j.1523-1755.2003.00005.x

Ishani A, Blackwell T, Jamal SA, Cummings SR, Ensrud KE, Investigators for the M (2008) The effect of raloxifene treatment in postmenopausal women with CKD. J Am Soc Nephrol 19(7):1430–1438. doi: 10.1681/ASN.2007050555