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Title: Patients with End-Stage Renal Disease.
Agency: Agency for Health Care Policy and Research/Center for Health Care Technology (formerly the Office of Health
Contact: Martin Erlichman, M.S., and Thomas V. Holohan, M.D., FACP.
Status: Technology Assessment: Published, 1996.
Primary Objective: To assess which techniques, if any, are clinically useful in the medical management of patients with bone loss due to end-stage renal disease.
Methods Used: Review of published literature, collection of information from major institutions and Federal agencies and interested parties in response to a Federal Register notice of intent to undertake assessment.
Data Identification: Published literature identified by search of the MEDLINE database of articles published between
1986 and 1994.
Study Selection: All published material of primary data addressing bone mineral density in ESRD patients and studies reporting BMD measurements and the incidence of fractures.
Data Extraction: Type of study, size of sample, method and site of measurement, bone loss measured and fracture incidence compared to controls.
Key Findings: Although bone loss has been demonstrated in patients with renal failure, evidence supporting the clinical
utility and appropriate role for bone mineral density measurements by any technique at any site in the management of
patients with renal failure is lacking.
Conclusion: Bone mineral density measurements currently do not provide useful information that could support therapeutic decisions in the management of end-stage renal disease patients.