Několik slov úvodem

prof. MUDr. Vladimír Palička, CSc., Dr.h.c.

Clin Osteol 2025; 30(1): 3

A completely now approach to the issue of bone disease in patients with chronic kidney disease -⁠ what KDIGO practice recommendations can we expect? Commentary on the KDIGO 2025 Controversies Conference.

Palička Vladimír, Sulková Dusilová Sylvie

Clin Osteol 2025; 30(1): 6-12

In 2006, the KDIGO initiative acknowledged the link between cardiovascular damage and bone disorders by incorporating a so called "vascular component" into the CKD-MBD concept. However, renal osteodystrophy continued to be viewed as a distinct and specific bone pathology within nephrology.In recent years, this perspective has begun to shift. Renal osteodystrophy, traditionally the domain of nephrologists, and osteoporosis, the domain of osteologists, are now increasingly converging and overlapping. The impetus for this change came from new insights into the importance of bone densitometry in nephrology and the high fracture risk among nephrology...

From despair to results: Clinical experience and effective strategies in the treatment of calciphylaxis

Krošlák Oliver, Sulková Dusilová Sylvie, Šafránek Roman, Halouzka Tomáš, Pokorná Anita, Chrobok Viktor, Horáček Jiří, Pavlíková Ladislava, Palička Vladimír

Clin Osteol 2025; 30(1): 14-20

Calciphylaxis (CUA) represents a rare but serious complication in patients with chronic kidney disease and less frequently in other conditions. The aim of our study is to assess our experiences with the diagnosis and treatment of CUA. We present the clinical characteristics, the prevalence of key risk factors, and the favorable prognosis of patients with calciphylaxis treated at our institution between 2014 and 2021. The cohort consisted of 23 patients who were diagnosed with calciphylaxis based on clinical presentation. In most cases, the lesions were multiple, painful, and led to significant mobility limitations. Important risk factors included the...

Vitamin D -⁠ current overview of the issue and specifics in nephrological practice

Sulková Dusilová Sylvie, Šafránek Roman, Pavlíková Ladislava, Pokorná Anita, Kadlec Mirko, Hudík Filip, Horáček Jiří, Hyšpler Radomír, Palička Vladimír

Clin Osteol 2025; 30(1): 22-29

Recent randomized placebo-controlled trials did not demonstrate clear clinical benefits of nutritional vitamin D supplementation in non-selected population. Therefore, current recommendations suggest testing vitamin D serum values only in vitamin D deficiency risk groups of patients. Kidney disease patients are at this risk.Target serum calcidiol (25-hydroxyvitamin D) concentrations in kidney disease or failure and also in kidney transplant patients should be higher than 75 nmol/l. The reason for this target is to maintain sufficient calcitriol to suppress early parathyroid gland overactivity. On the contrary, calcidiol values over 50 nmol/l are...

Selected stories from osteonephrology -⁠ an introduction

Sulková Dusilová Sylvie, Pavlíková Ladislava, Pokorná Anita, Jiráčková Jana, Hudík Filip, Malá Alena, Bílková Lenka, Matysková Michaela, Hyšpler Radomír, Šafránek Roman, Palička Vladimír

Clin Osteol 2025; 30(1): 30-34

Vybrané příběhy z osteonefrologie -⁠ úvod do problematikySo called osteonephrology deals with the interface between metabolic and other consequences of complex bone and cardiovascular disease in renal disease and also with non-renal metabolic osteopathies in kidney patients.The article focuses on problems associated with biologic therapy of osteoporosis in patients with chronic kidney disease, including dialysis as well as kidney transplantation. The attention is paid not only to benefit of this therapy, but also on its possible risk, showing the importance of carefull monitoring in hands of nephrologists.

The role of palopegteriparatide in the treatment of hypoparathyroidism

Králik Roman; Pavúková Simona; Payer Juraj; Kužma Martin

Clin Osteol 2025; 30(1): 42-45

Hypoparathyroidism is a rare endocrine disorder characterized by insufficient secretion of parathyroid hormone, leading to hypocalcemia and its severe clinical consequences. While there are various etiological forms, the most common cause is post-surgical removal of the parathyroid glands, such as after total thyroidectomy. Diagnosis is based on low parathyroid hormone levels combined with hypocalcemia and other biochemical changes. Clinical manifestations range from mild neurological symptoms to life-threatening complications such as laryngospasms and cardiac arrhythmias. Long-term complications include nephrolithiasis, renal insufficiency, and alterations...

Hypophosphatasia -⁠ Standard Diagnostic and Therapeutic Guidline

Kužma Martin, Tichá Ubica, Kokavec Milan, Payer Juraj

Clin Osteol 2025; 30(1): 48-53

Hypophosphatasia (HPP) is a rare hereditary disease with a variable course, caused by mutations in the ALPL gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). It is characterized by impaired bone and tooth mineralization, growth and mobility disorders, premature tooth loss, respiratory issues, and seizures. Diagnosis is based on low ALP activity and elevated levels of its substrates. Early diagnosis is crucial, as improper treatment can worsen the patient's condition. Molecular genetics can confirm the diagnosis, though it is not always necessary. Treatment includes enzyme replacement therapy and symptomatic care to manage complications.

Secondary Osteoporosis

Horák Pavel

Clin Osteol 2025; 30(1): 54-60

Osteoporosis is a major public health problem. Although postmenopausal and involutional osteoporosis are the most common forms, secondary causes account for up to 30 % of osteoporosis in postmenopausal women, 50 % of premenopausal osteoporosis, and 80 % of osteoporosis in men. Causes of secondary osteoporosis include lifestyle and nutritional factors, diseases that contribute to the development of bone metabolic disorders, and iatrogenic causes related to pharmacological or nonpharmacological interventions for various conditions. The need for screening for secondary causes of osteoporosis depends on the severity of osteoporosis, the absence of obvious...

Predikcia osteoporotických zlomenín na základe intenzity signálu MR?

Mikulová Udmila, Gičová Daša, Špakovská Tatiana, Lorinczová Zuzana, Kalafu-Tová Soňa, Blaščáková Mydlárová Marta

Clin Osteol 2025; 30(1): 36-40

Výber z najnovších vedeckých informácií v osteológii

Šteňová Ke Em

Clin Osteol 2025; 30(1): 61-62