Medicine Grand Rounds

"Management of Osteoporosis in Patients with CKD"
Thomas Nickolas, MD
Dr. Nickolas is an Associate Professor of Medicine at Columbia University Irving Medical Center and a member of the Division of Nephrology. He trained in Internal Medicine at the University of Pennsylvania and Nephrology at Columbia University. He is a member of the KDIGO Bone Quality Working Group. His primary interests are in the skeletal effects of kidney disease, focusing on clinical and translational studies of bone cell signaling and bone microarchitecture. Patients with chronic kidney disease have poor bone strength and increased fracture risk due to older age, excessive inflammation and frailty, and metabolic complications of and medications used to treat kidney disease. Hip and spine fractures are particularly common and can result in an increased morbidity and mortality. The goal of his work is to identify mechanisms that will lay the groundwork for the development and study of novel and effective strategies that will preserve skeletal integrity and prevent bone loss and fractures in patients with kidney disease. His lab uses high resolution in vivo bone imaging to identify how the kidney differentially impacts cortical versus trabecular bone. His group described mechanisms that underly paradoxical observations of increased fracture risk in de novo kidney transplant recipients despite increased or preserved bone mineral density. Recently, his group identified novel circulating markers of bone turnover based on microRNA methods that are highly accurate for the non-invasive diagnosis of renal osteodystrophy type. Further development of these findings is critically relevant to the diagnosis, treatment and monitoring of kidney related bone disease.

Department of Medicine Grand Rounds
The University of Arizona College of Medicine - Tucson is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The University of Arizona College of Medicine - Tucson designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Disclosure Statement:
All Faculty, CME Planning Committee Members, and the CME Office Reviewers have disclosed that they have no financial relationships with ineligible companies that would constitute a conflict of interest concerning this CME activity.
Learning Objectives:

• Diagnose a variety of internal medicine illnesses
• Understand more clearly advances in therapy
• Become truly professional physicians