Please select the option that best describes you:
Topics:
Rheumatology • General Rheumatology • Endocrinology • Bone and Calcium Disorders • General Endocrinology • Paget
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...
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.
Thank you, Dr. @Lane!