Abstract：
Fracture risk assessment in patients with chronic kidney disease (CKD) has been included in the CKD-MBD (\"Chronic Kidney Disease-Mineral and Bone Disorders\") complex in international and national nephrology guidelines, suggesting for the first time the assessment of bone mineral density (BMD) if the results can influence therapeutic decision-making. However, there is very little information on actual clinical practice in this population. The main objective of the ERCOS (ERC-Osteoporosis) study is to describe the profile of patients with CKD G3-5D with osteoporosis (OP) and/or fragility fractures treated in specialized nephrology, rheumatology and internal medicine clinics in Spain. Fifteen centers participated and 162 patients (mostly women [71.2%] postmenopausal [98.3%]) with a median age of 77 years were included. Mean estimated glomerular filtration rate (eGFR) was 36 mL/min/1.73 m2 and 38% of the included patients were on dialysis. We highlight the high frequency of prevalent fragility fractures [37.7%), mainly vertebral (52.5%) and hip (24.6%)], the disproportionate history of patients with glomerular disease compared to purely nephrological series (corticosteroids) and undertreatment for fracture prevention, especially in nephrology consultations. This study is an immediate call to action with the dissemination of the new, more proactive, clinical guidelines, and underlines the need to standardize a coordinated and multidisciplinary care/therapeutic approach to these patients in an efficient way to avoid current discrepancies and therapeutic nihilism.
摘要：
慢性肾脏病（CKD）患者的骨折风险评估已被纳入国际和国家肾脏病指南中的CKD-MBD（“慢性肾脏病-矿物质和骨骼疾病”）。首次建议评估骨矿物质密度（BMD）的结果是否会影响治疗决策。然而,关于该人群的实际临床实践的信息很少。ERCOS（ERC-骨质疏松）研究的主要目的是描述CKDG3-5D伴骨质疏松症（OP）和/或脆性骨折的患者在专门的肾脏病学治疗中的概况，西班牙风湿病和内科诊所.参加了15个中心，其中162名患者（大多数是女性[71.2％]绝经后[98.3％]），中位年龄为77岁。平均估计肾小球滤过率（eGFR）为36mL/min/1.73m2，纳入患者中有38％进行透析。我们强调了普遍存在的脆性骨折的高频率[37.7%)，主要是椎体(52.5%)和髋关节(24.6%)]，与单纯肾病系列（皮质类固醇）和骨折预防治疗不足相比，肾小球疾病患者的病史不成比例，尤其是在肾脏病咨询中。这项研究是立即呼吁采取行动，传播新的，更积极主动,临床指南,并强调需要以有效的方式规范对这些患者的协调和多学科护理/治疗方法，以避免当前的差异和治疗虚无主义。
