Management of Long Bones Metastatic Disease: Concepts That We All Know but Not Always Remember.

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Abstract

Conflict of interest statement: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. No author involved in the writing of this manuscript receives any funding from industry, holds research grants, or has a conflict of interest that could influence this elaboration of the manuscript. 14. Nephrol Dial Transplant. 2017 Oct 1;32(10):1608-1613. doi: 10.1093/ndt/gfw468. Bone biopsy practice patterns across Europe: the European renal osteodystrophy initiative-a position paper. Evenepoel P(1), D'Haese P(2), Bacchetta J(3), Cannata-Andia J(4), Ferreira A(5), Haarhaus M(6), Mazzaferro S(7), Lafage Proust MH(8), Salam S(9), Spasovski G(10), Cozzolino M(11); ERA-EDTA Working Group on CKD-MBD. Author information: (1)Department of Immunology and Microbiology, Laboratory of Nephrology, KU Leuven - University of Leuven and Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Belgium. (2)Department of Biomedical Sciences, Laboratory of Pathophysiology, Antwerp University, Wilrijk, Belgium. (3)Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Bron, France. (4)Hospital Universitario Central de Asturias, Oviedo University REDinREN IIS Carlos III, Bone and Mineral Research Unit, Oviedo, Spain. (5)Nova Medical School - Faculdade de Ciências Médicas da Universidade Nova de Lisboa e Centro Hospitalar Lisboa Central - Hospital de Curry Cabral, Lisboa, Portugal. (6)Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, Karolinska Institutet and Department of Nephrology, Karolinska University Hospital, Stockholm, Sweden. (7)Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University, Rome, Italy. (8)SAINBIOSE, Université de Lyon, CHU, Saint-Etienne, France. (9)Sheffield Kidney Institute and Academic Unit of Bone Metabolism, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. (10)Department of Nephrology, Medical Faculty, University of Skopje, Macedonia. (11)Department of Health Sciences, Renal Division, San Paolo Hospital, University of Milan, Milan, Italy. Renal osteodystrophy (ROD) is a heterogeneous group of metabolic bone diseases complicating progressive chronic kidney disease (CKD). Bone biomarkers and bone imaging techniques may help to assess bone health and predict fractures in CKD but do have important inherent limitations. By informing on bone turnover and mineralization, a bone biopsy may help to guide prevention and treatment of ROD and its consequences. According to a recent survey conducted among European nephrologists, bone biopsies are performed rather exceptionally, both for clinical and research purposes. Obviously, clinical research in the field of ROD is threatened by vanishing clinical and pathological expertise, small patient cohorts and scientific isolation. In March 2016, the European Renal Osteodystrophy (EU-ROD) initiative was created under the umbrella of the ERA-EDTA CKD-mineral and bone disorder (MBD) Working Group to revitalize bone biopsy as a clinically useful tool in the diagnostic workup of CKD-MBD and to foster research on the epidemiology, implications and reversibility of ROD. As such, the EU-ROD initiative aims to increase the understanding of ROD and ultimately to improve outcomes in CKD patients. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. DOI: 10.1093/ndt/gfw468