Consensus Evidence-Based Clinical Practice Recommendations for the Diagnosis and Treat-To-Target Management of Osteoporosis in Chronic Kidney Disease Stages G4-G5D and Post-transplantation: An Initiative of Egyptian Academy of Bone Health

Yasser El Miedany; Naglaa Ali Gadallah; Eman Sarhan; Mathias Toth; Mona Mansour Hasab El Naby; Mohamed Elwy; Sahar Ganeb; Maha El Gaafary; Mohamed Mortada; Samah Ismail Nasef; Nevine Mohannad; Safaa Ali Mahran; Mohammed Hassan Abu-Zaid; Mervat Eissa; Waleed Hassan; Basma M Medhat; Rasha Ghaleb; Samar Abdelhamed Tabra; Heba Gamal Saber; Rehab Ali Ibrahim; Sally Saber; Salwa Galal

doi:10.1159/000526492

Kidney Diseases (Oct 2022)

Consensus Evidence-Based Clinical Practice Recommendations for the Diagnosis and Treat-To-Target Management of Osteoporosis in Chronic Kidney Disease Stages G4-G5D and Post-transplantation: An Initiative of Egyptian Academy of Bone Health

Yasser El Miedany,
Naglaa Ali Gadallah,
Eman Sarhan,
Mathias Toth,
Mona Mansour Hasab El Naby,
Mohamed Elwy,
Sahar Ganeb,
Maha El Gaafary,
Mohamed Mortada,
Samah Ismail Nasef,
Nevine Mohannad,
Safaa Ali Mahran,
Mohammed Hassan Abu-Zaid,
Mervat Eissa,
Waleed Hassan,
Basma M Medhat,
Rasha Ghaleb,
Samar Abdelhamed Tabra,
Heba Gamal Saber,
Rehab Ali Ibrahim,
Sally Saber,
Salwa Galal

Affiliations

Yasser El Miedany: ORCiD; Rheumatology, Canterbury Christ Church University, Canterbury, UK
Naglaa Ali Gadallah: Rheumatology, and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Eman Sarhan: Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mathias Toth: Rheumatology, Darent Vally Hospital, Dartford, UK
Mona Mansour Hasab El Naby: ORCiD; Rheumatology, and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mohamed Elwy: Rheumatology, and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Sahar Ganeb: ORCiD; Rheumatology, Faculty of Medicine, Benha University, Benha, Egypt
Maha El Gaafary: Community Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mohamed Mortada: ORCiD; Rheumatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Samah Ismail Nasef: ORCiD; Rheumatology, and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Nevine Mohannad: ORCiD; Internal Medicine and Rheumatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Safaa Ali Mahran: ORCiD; Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt
Mohammed Hassan Abu-Zaid: ORCiD; Rheumatology, Faculty of Medicine, Tanta University, Tanta, Egypt
Mervat Eissa: ORCiD; Rheumatology, Faculty of Medicine, Cairo University, Cairo, Egypt
Waleed Hassan: Rheumatology, Faculty of Medicine, Benha University, Benha, Egypt
Basma M Medhat: Rheumatology, Faculty of Medicine, Cairo University, Cairo, Egypt
Rasha Ghaleb: ORCiD; Rheumatology, and Rehabilitation, Faculty of Medicine, Minia University, Minia, Egypt
Samar Abdelhamed Tabra: Rheumatology, Faculty of Medicine, Tanta University, Tanta, Egypt
Heba Gamal Saber: Geriatric Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Rehab Ali Ibrahim: ORCiD; Rheumatology, and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Sally Saber: Rheumatology, and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Salwa Galal: Rheumatology, and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt

DOI: https://doi.org/10.1159/000526492
Journal volume & issue: Vol. 8, no. 5
pp. 392 – 407

Abstract

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Objective: The aim of this study was to reach a consensus on an updated version of the recommendations for the diagnosis and Treat-to-Target management of osteoporosis that is effective and safe for individuals with chronic kidney disease (CKD) G4-G5D/kidney transplant. Methods: Delphi process was implemented (3 rounds) to establish a consensus on 10 clinical domains: (1) study targets, (2) risk factors, (3) diagnosis, (4) case stratification, (5) treatment targets, (6) investigations, (7) medical management, (8) monitoring, (9) management of special groups, (10) fracture liaison service. After each round, statements were retired, modified, or added in view of the experts’ suggestions, and the percent agreement was calculated. Statements receiving rates of 7–9 by more than 75% of experts’ votes were considered as achieving consensus. Results: The surveys were sent to an expert panel (n = 26), of whom 23 participated in the three rounds (2 were international experts and 21 were national). Most of the participants were rheumatologists (87%), followed by nephrologists (8.7%), and geriatric physicians (4.3%). Eighteen recommendations, categorized into 10 domains, were obtained. Agreement with the recommendations (rank 7–9) ranged from 80 to 100%. Consensus was reached on the wording of all 10 clinical domains identified by the scientific committee. An algorithm for the management of osteoporosis in CKD has been suggested. Conclusion: A panel of international and national experts established a consensus regarding the management of osteoporosis in CKD patients. The developed recommendations provide a comprehensive approach to assessing and managing osteoporosis for all healthcare professionals involved in its management.

Published in Kidney Diseases

ISSN: 2296-9381 (Print); 2296-9357 (Online)
Publisher: Karger Publishers
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine
Website: http://www.karger.com/kdd

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