Webinar: Osteoporosis and chronic kidney disease by MAH Conferences

Osteoporosis 2021

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About This Webinar

A treatment gap exists between those at risk of fracture and those receiving treatment for the prevention of fractures. This gap is likely to be wider in patients with chronic kidney disease (CKD) stage 4-5D (eGFR below 30 ml/min 1.73 m²). In these patients, impaired bone strength, related to low bone mass and impaired bone quality, and an increased tendency to fall, contribute to a very high fracture risk. Fractures are more frequent and more dangerous than in non-CKD populations. Additionally, there is concern, some of it probably misplaced, as to the efficacy and safety of standard osteoporosis treatments in renal populations - therapeutic nihilism is common.

CKD is a state of accelerated ageing and thus primary, age-related osteoporosis may develop at an earlier age driven by traditional risk factors for osteoporosis apply to patients with CKD stage 4-5D as well. Bone fragility in CKD is thus a composite of primary osteoporosis and adverse skeletal effects of drugs, disturbances of mineral metabolism, and the uraemic milieu.

A coherent approach to screening/testing and a clearer understanding if the benefits vs risks of intervention should lead to better and more widespread utilisation of available therapies.

Presenter

Professor John Cunningham

Professor of Nephrology, University College London & Royal Free London NHS Foundation Trust

John Cunningham is a clinician-scientist holding positions as Professor of Nephrology at University College London Medical School and The Royal Free Hospital and an Honorary Fellowship at Trinity Hall, University of Cambridge. He is a graduate of the universities of Cambridge and Oxford followed by postgraduate training in London and Washington University School of Medicine, St Louis, under Drs Louis V Avioli and Eduardo Slatopolsky.

He is an active clinician and researcher with contributions to the understanding of the effect of acidosis on the bioactivation of vitamin D, the influence of simulated uraemia and vitamin D on the release of cytokines by bone cells, factors mediating bone loss following renal transplantation and the control of parathyroid function by structurally modified vitamin D metabolites and calcimimetics. Later his work has focussed also on the links between mineral metabolism and cardiovascular disease in chronic kidney disease.

He serves on various grant giving bodies and guideline groups. He lectures nationally and internationally and is co-chairman of the Nephrology At The Limits series held under the auspices of University College London, The University of Cape Town, The Brigham and Women’s Hospital and The Lancet.