How do you approach a patient with Paget’s disease of bone with elevated alkaline phosphatase and history of chronic kidney disease?

Patient with a history of CKD stage 4. Alkaline phosphatase 4x upper limit of normal.

Answer from: at Academic Institution

You can give Zol IV, which is clearly the optimal treatment for active Paget's. Those in the field that treat many such patients just administer this very slowly over 1-2 hours and assure good hydration concomitantly. I have treated a number of patients like this, with this scenario, without any pro...

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at Bay Area Arthritis and Osteoporosis
Thank you.

Answer from: at Academic Institution

Tough one. I might try low-dose risedronate and monitor the calcium and creatinine values often.

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at Bay Area Arthritis and Osteoporosis
Thank you, Dr. @Lane!

Answer from: at Community Practice

Agree with Dr. @Lane. Not everyone with active Paget’s disease of bone needs pharmacologic treatment. The risks of treatment need to be carefully considered.

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at Bay Area Arthritis and Osteoporosis
Thank you.

at George Washington University School of Medicine
Older data would suggest that salmon calcitonin wo...

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How do you approach a patient with Paget’s disease of bone with elevated alkaline phosphatase and history of chronic kidney disease?

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