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Treatment of bone fragility in CRF
Pr.Dr O. Lamy, Lausanne
Friday, May 13, 2022 · 3:27 p.m. · 27m 14s
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there we go so thank you for joining us um the the floors yours
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yes thank you for the public to give me the opportunity
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to speak about the subject without any of the dance stuff so
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i i propose a shot plan to gave
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an overview of so concept of bowling uh fragility
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uh in c. v. if uh quite make caravan and
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disease at about a d. x. say about the biological markers
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and the most of that uh it's a it's a presentation i will
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talk about a different treatments are are of us were born a fragility
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i i really folk who is a is a presentation and only on the issue and uh
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who is lowell a tea house of crap t.
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means so below self cheek a midi expect mean you'd
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so for patient at least g. four g. five and
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g. five d. for haitian her on a a jellies
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if you are looking at us respond find you and you can see that
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or is the treatment can be given for people to uh we said
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p. house of catching in a bowl of a self teenage expect me need
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which is a exception a false is only the hynek uh as seed
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but when we have a clear house of kathleen
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below self to mediate their minutes we have uh
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you know i mean only one or two treatment like uh the amount
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that up excuse me or the mob can be given without any adjustment
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for that i that we can give it a
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a a photo of crafting mean value low wells
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on a one hundred seventy seven so clear houses
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not given bust uh aunt only as a crafty nina
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and we and we have an exception for so you don't why not
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for the i. d. of uh those these off one one
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eight is it clear policies below seventy mediated that mean you
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we can give to wouldn't do me harm and not sweeney calm
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and in a one hour of and and not even a defector injection
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as you would know oh so corny kidney disease is a systematic
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other diseases not only the dental disease or only a bone a disease
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it's a systematic disease that combines abnormalities of
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metabolism of calcium phosphate therapy th a vitamin d.
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a a a problem with vascular are or
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so soft as you can see vacation and a
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lot of the of a abnormalities in bone ten
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of a mile a minute is asian or strings
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concerning the different concept by and findings uh
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off the board mean a handy dissolve about
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uh uh uh it is very important to the uh after treatment
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offices born mean high dean's these all the bells and
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z. streets man's include the phosphate lover reading tweak men's
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only in case off i'd before starting yeah uh uh uh to avoid there i have
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that same yeah and in guide easy station uh huh quieting p. t. i. shelving to happy
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kyle cinematic sky sickly all all the time
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in the uh analogue alone or in combination
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but despite a good uh kampala
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offices dissolved office or a is a
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i mean i'm in jail easy station so effective
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at least uh as a yet but uh decrees
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concerning all still policies and a factor
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in a patient was clinic it may disease
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uh uh it is well no one's as effective incidence
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increases who is a is a chronic kidney disease stages
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and for example in g. i. disease patients uh he scoffed hock shop
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is four times a idea of design incision hi you're a population
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and it is clear that are still posey since only one part of the skillet panel
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there are complications that include a still my last yeah and uh or stay uh or stay with this coffee
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even they he packed lisa uh on t. i. has of t. v.
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and then nobody cash and support postal poses as for those whose compendium out
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uh he used off label in i at least a patient with c. g.
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forty five or a or in patients on a on a gen disease but
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in practically is often that uh on t. f. s. l. p. should
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be then in high his patient with high bone tone of uh of
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and was there whenever you catch ends in i actually station we slobodan not a ton of though but
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is that is uh on the general uh a configuration
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there is often question uh about the whole of d. x.
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say yeah in the parent we so corny could nay a disease
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are consenting we have a lot of the telecom sounding costs extra nylon longitudinal
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uh studies uh which is a is a d. m. d. and we know
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is that where willow small caustic analysts on particular one rose
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and zap bowed low bone mineral density is associated with sending precisely stuff hard
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shell and predict the increase ways of uh a fucked up so d. m. d.
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uh can be used uh in uh
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the evaluation of people was clinic kidney disease
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for t. d. s. we have some data uh in the i.
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d.s this population and after kidnap
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constipation back for fast self evaluations
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her heart needed and vegetable factor of a assessments of the a. f. ah
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he's a deafening testing false of esteban factual assessment
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but might be probably interesting to evaluate is a ousted can see vacation
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in this population at very high fees for cardiovascular out of a disease
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concerning the you can you can do the markers in uh is this population now
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uh uh we know in some say he's about about this safeties are
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always small unzip quality of this safety is is a a discrete table
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but sample mark i live in a first fat days and p. t. h.
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uh the whole at t. v. who would a page t. the value
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for jack knows seeing the i have a hard to avoid or i do not need to bone disease
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but when we are you looking to this sense e. d. t. or
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specific c. t. c.s value are between seven t. m. i. t. or accent
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in the studies and he's a yeah i guess when she between that
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that first part as our kind i met and a fact use he's got
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the hydration sheet between the th and factory
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actual uh you of a g. period of uh
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and the e. pieces so important to to size at the first buttons are kind i know
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a bone specific pressed up as an ally in pop five be ah not clay he'd buys it pete may
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and so i think i've paid high table in people
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we scorn you could make a a corny kidney disease
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for the boat on the valve mark a flight p. one
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and p. n. c. t. a. x. one value is not
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interest pretty bad in case of corny kidney disease but we
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can anticipate the to attend the between two or see the values
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so for the fact your face get valuation in clinic kidney disease that
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is a is a clinical his factor for or
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still poses how's the same as incision earhart population
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but z.'s people observe clinic kidney disease as an additional uh he's a fact stuff
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the uh if we calculate uh there's a factor fees suisse facts
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um uh is a chronic kidney disease does not include that as independent he's fact though
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four or still policy send fax underestimates the phase
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of uh was still property talk show in this population
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and concept innings a whole commendation for the treatment as
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a whole commendation might be the same as incision behind population
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uh when we have of high g. t. fracture when we have
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a t. scoff uh do you do you mean use two point five
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or depending uh on the countries uh according to the entire lunch on
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a special word when we was a flask so a special for the treatment
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so concerning the it's a treatment that i can
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to the the first one eight uh uh we
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is this is is a group of medication in which we have the most they top
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always d'etat uh coming from from deftly small uh studies so
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the degree of evidence the is uh is uh they feel
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the uh oh we should we know very well is that a
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a beef was fun at a a seven be postponed that half life
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he's a increase in a in a corny kidney disease
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and uh is there is a an accumulation in the finale accumulation
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in a clinic uh quite a kidney disease to
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be first phone eight actually effort by jane easy so
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but uh we have always uh uh we are
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aware about uh it's a cheat ne injury about
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with the first fun night we we have a high highly uh and in actuate je
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ne uh i'm sure he uh like uh uh not used to be on the closes
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or a blue metrical skew hoses you to uh differs from
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uh uh uh it is important to to say zap low won't don't over it is not
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a key while down to i do not need to bone disease uh on the ball and uh
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a biopsy and noble and don't of uh
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uh based on biochemical mascot is not a good
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agreement to side it is not possible to be even enter has all the uh to happy
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and so bone biopsy p. o. of a onto has opted
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to happy op p. o. b. first fanatically station is not mandatory
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uh buys the international directed nay a society
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that is probably will be probably into hastings a problem
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after that is how to interpret the biopsy and we haven't
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study uh exact folk choose one or has all treatment
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i got a according to the results of the the idea biopsy
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with one exception for the coffee pot tied i will speak about the the after
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in a a study wispy first fun that up to the uh cognitive needy sees
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a g. for the first fun not uh mostly all high the first one eight
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hi this is saying efficacy t. as incision behind population in
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town of a d. m. d. d. a. in the or
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in town of a fight use a factory of uh of fees that
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and there is no heavy dose disaster level of vomiting separation is defect
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found in clinic kidney disease and in no and a clinic kidney disease
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uh some people are you give a identity for the first one application men's
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uh yeah i kinda off those ease of uh uh no hard those or one i. e. v. those ease
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but uh uh z. strategies uh on that uh my d. d. t.
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global he still has you been a feast takes care is probably is is saying
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in patients with g. forty five g.
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file d. as incision highly uh a population
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and uh it is clay asset inpatient without busied you and i have not found function
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uh i d. be first from that uh can be used uh uh
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in this population wise that is no more a high not a face
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that in case of a a twenty kidney disease
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four and five we so paul that i see that
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uh increase uh will probably see decline or of g. u. e. g. f. a. or
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a a differs from that there should be a avoid it uh in this uh cases he's
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due to the potential he's of an acceleration of sees a dateline
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just one treatment second don't get has opted for banners you not that uh uh uh the thought mac
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within a peak of the noisy mad but uh is
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the same according to the defence on a stage uh
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of uh okay now you're a disease that's it's a a good new was
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that is uh probably um yellow is a up your house of see the hypo chi same yeah for
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two months uh inpatient on a gen disease patients
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and uh this probably them uh uh is uh i
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about was the scribe in people with chief oh hi angie five
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uh to still in people uh uh uh uh with g. fall you will have a
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feast of uh i people are saying yeah love see the people kind of san yeah
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and it is very important uh to to to do those kinds shown to
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do was a vitamin d. and to believe i do was ease of calcium
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and they can mean d. and perhaps i'll see clearly in
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in the station before uh to be uh uh uh dinners you
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i i summarise uh it just won a a a a case safeties
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of a fourteen a patient with a sick add a four and five and you can see
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uh the clean it can uh excuse me the clinical probably am
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might be might be uh as say there has a say so
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of nothing less last month a you can see the
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is it the trees in this uh people uh four or
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fast uh to ones uh i seen a g. i. d.s use a page
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and so as a programmer as uh we talk
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about the is what to do uh at the
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builders you mad this continuation we have to believe uh the first one eight we have to be
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i yeah those east of the first one eight us
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that those z.'s as we are given incision atlanta still proposes
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uh so it might be a problem in the people we set
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plug receive a decline a of a of a non uh function
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so not only the first one eight on needed at
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dinner zoom out this continuation but i of those these
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uh as a user again uh those uh uh to
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uh avoid is a is a factory of a face
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terry patty that is uh uh interesting uh uh
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in case is a of a default angie five that
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we have some uh they uh was a fifty a low number of patients
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uh but we have pleasing results in a woman with a g.
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four twenty five and that is that the seemed yeah easy station
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fox used only on patient with hypothetically decent walk
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in patients with paul then i deny me bone disease
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duncan jen disease patients to hit the high tide wise use in these f. t. p. r.
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uh it's a keen and in this state team get a boeing
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a high density and by you must go of bone formation uh increase
00:17:40
as a treatment you haitian shoot the not to exceed the to to
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your alsace incision harder still proposes bat and so and especially patty that
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each day and he a man to has a piece to happy over the first fun that
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this month that all he to present elf uh
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is again a of a board minute and a density
00:18:05
almost as you're not that it is sent m. s. n. to see that for the f. d.
00:18:09
a. is a reasonable uh the t. howls a
00:18:14
limitation to prescribe a home was a zoom out that
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but the problem with how much as you mad but uh
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is uh increase he's of a second use cardiovascular yeah uh events
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and people who was clinic kidney disease out a hot i feast
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off a a cardiovascular disease and then as a problem
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then is what to do a odds uh and of the
00:18:40
whole muslim how much as you mob due to the rebound effect we have to be it would be first phone eight
00:18:46
or the news you made that and we have the
00:18:48
same problem uh asked for a decade a happy but uh
00:18:55
and thoughts in this uh uh they uh uh uh i i do not
00:19:01
know where he wears this topic backed up by hand this to host team that
00:19:06
uh is uh as a protective uh
00:19:09
uh hold on a vascular hubble either and
00:19:14
if i have always uh on this catalyst in uh we we block
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a week and a we can have an increase of vascular uh
00:19:24
tell c. t. creation and fossil tells a of this whole view
00:19:30
a a home was easy mob a master not to
00:19:33
be used in a is this type of a population
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i show yeah uh of actually access on the pop was i am in
00:19:45
a fun uh against there to get a in a yeah easy station doesn't
00:19:51
this concept only get easy spatial and and that g. for n. g. five haitian
00:19:57
and uh the bone biopsy is mom that or feedback if the bone biopsy ease
00:20:04
not to have a have a very uh they they better the proposal is to assess
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p. t. h. and uh uh both specific of us bypass alkaline and
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if p. t. age is nine time idea as a repair on the flange
00:20:20
and one specific first that as an ally in about uh not mind high and it is possible to
00:20:27
initiate load those or how to uh uh the
00:20:29
first one eight but for all also cases against that
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uh propose a bone biopsy and after that to be the
00:20:38
a two guys a treatment i call the according to users results of the bone biopsy
00:20:45
i i say a it is a problem easily i haven't any study uh
00:20:52
mm with side out to guide treatment according to
00:20:56
the resound uh our uh due to the bone biopsy
00:21:01
so in in conclusion uh uh uh we can sizes at a
00:21:05
abnormalities in boarding a couple is remind portly on just to the
00:21:10
d. x. say ease use a full philosophies talk shop production
00:21:16
tape apartheid seems to be the safest treatment
00:21:19
in case of a dynamic uh born a disease
00:21:23
and the first one it's ah staffing the and the use in say there
00:21:28
acquainted kidney disease and so facial been if e. p. steep probably
00:21:32
ideas on expected then as you map is probably one kind dictated does it do
00:21:39
to the population of the clean air clinically need a quite need kidney disease and
00:21:44
the impossibility of a mad jeans every bone defect and how much as you might
00:21:49
be scone kind cared for a safety the reason i sent you for your intention
00:22:02
for the the overview
00:22:05
the paper is open for questions these cautions um
00:22:10
i was surprised initially is that the boat marcus or
00:22:13
not of use to exclude a kinetic bone disease i'm
00:22:17
happy to see at the end the algorithm which include
00:22:21
the a. p. and p. th i think in fact um the or
00:22:24
study showing that they have a sensitivity to excuse they couldn't bone disease
00:22:29
then the courtyard thought it would be to do to perform a bone
00:22:32
biopsy the essence and i don't know my question is are you doing laws
00:22:36
on bone biopsy now where we don't make any bone biopsy and it's the
00:22:41
same crossing both but i think using bone more 'cause all quite had proof
00:22:46
not with a one hundred percent sensitivity but t. v. i think in which direction a bone to always go yes
00:22:52
i thought they said he was by the bone biopsy
00:22:58
we are i think you up with the for for for these acts and review of um
00:23:03
i i i in principle group agree with everything you said
00:23:07
and i myself for a full body away from we participated to go
00:23:12
for the guidelines that you've shown from from the davenport
00:23:16
from do you all go the fro geo european group
00:23:19
we said that we are currently own to using or is forced phone it's
00:23:24
seen patients with those stage three before if we should use more of them
00:23:31
and it became aware of the meta analysis of robin's song feet will long
00:23:36
ride say draw that demonstrate that all these four sundays in stage three beep last
00:23:43
accelerate gloss over your function sort of the passage from three to four
00:23:49
is accelerated by the use of even small balls award before
00:23:53
the need in their huge make the analysis whatever they do so
00:23:56
what was so good that i did you really put more control just want to say that but i think we don't have to
00:24:03
do the complete picture on the renal safety or or this was funny
00:24:09
that question is for or just people yeah we'll go to that yeah easy is
00:24:15
it is better to go to that yeah easiest to yell ca tell wheeze one two weeks retraction
00:24:22
well two years oh he oh without any question watched was due
00:24:28
oh before that would this morning i'm thinking long dining the symposium
00:24:33
she said something quite intriguing when she showed though
00:24:36
resolve overall more according to this day job renal dysfunction
00:24:40
ensure the point i never thought about what you say for the say in ga for
00:24:45
it's not exactly the same risk if it is your
00:24:50
regularly declining share far over a cheating you know your scare all these
00:24:55
or or for the drummer relay or if you are the specific disease
00:24:59
you know like a diabetes bone disease or or even your immune bong
00:25:04
you knew no kidney disease or n. is that sort of thing that that
00:25:10
on a on a given on so i mean do you feel safe
00:25:15
to treat o. o.s thing three before with the this fourth one eight e. v. d.s
00:25:22
eight your lady with the regularly declining here for that go there by a gene or if
00:25:28
it is a six you or they have big dig a weasel more steep decline we don't function
00:25:35
i don't think it's good question but if not i guess it's sad to say okay
00:25:39
it's not just about the state of renal failure it's the context is upon want i think about
00:25:47
these are all patients very treat individualised i think taking
00:25:50
it doesn't count the kidney function do over or factories
00:25:54
or probabilities cardiovascular disease think that's the context of everything and i think
00:25:59
it's difficult to bring it on one one knife um um recommendation
00:26:08
i i i uh i participated long time but
00:26:13
collaboration of by evander nate and then it can do
00:26:18
a interpretation of the dock day to the golden way yeah
00:26:23
that the real proxies giddy pains mainly owns a plasma label
00:26:28
so uh it should be in a space for for the key then slowly
00:26:35
so that it never reaches an increase of a significant
00:26:40
increase last monday and cannot be dangerous to the k.
00:26:47
okay thank you peter that's we make sat and pauses the example with the one twenty eight
00:26:54
is to be if uh uh well those days and two beeps real we that's a degree
00:27:01
of if you dance is israel but but we made sees a instead they packed is yes
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