A 69-year-old woman with osteoporosis has a T-score of -2.8 at the femoral neck and a recent low-trauma distal radius fracture. She has eGFR 18

Question

A 69-year-old woman with osteoporosis has a T-score of -2.8 at the femoral neck and a recent low-trauma distal radius fracture. She has eGFR 18 mL/min/1.73 m2, calcium 9.2 mg/dL, phosphate 4.6 mg/dL, and PTH 150 pg/mL. She has severe reflux esophagitis. Which of the following is the most appropriate next step before selecting drug therapy?

Accepted Answer

Evaluate chronic kidney disease-mineral and bone disorder and fracture phenotype

Answer

Delay treatment for 10 years

Answer

Use calcitonin nasal spray as first-line long-term therapy

Answer

Start estrogen therapy

Answer

Start oral alendronate today

Osteoporosis in advanced CKD — ABIM Board MCQ