International Osteoporosis Foundation

It is.

This is precisely why the twenty twenty-five consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases, alongside the International Osteoporosis Foundation, strongly recommends bone-specific alkaline phosphatase for managing chronic kidney disease associated osteoporosis.

And I know the twenty twenty guidelines from the American Association of Clinical Endocrinologists and American College of Endocrinology, which we usually just know as ACE, also position it as a critical tool.

They allow its use when our preferred peptide markers are limited by renal insufficiency or frankly, even just insurance coverage barriers.

It’s so elegant.

It is.

This one-to-one stoichiometry is why the International Osteoporosis Foundation and the International Federation of Clinical Chemistry and Laboratory Medicine designate P1NP as the absolute reference marker for bone formation.

Wait, I want to pause on that renal clearance issue, though.

There definitely is a role of protein, and it's been fascinating watching the sort of overdosing of protein, the swing that has been occurring in the last couple years.

Especially because I remember, I don't know, 12 more years ago at a big International Osteoporosis Foundation conference, that protein was mentioned.

It was the first time I'd really heard this being touted in the bone health world.

And it was really targeting seniors who are under consuming protein.

...

there is a wonderful website by the International Osteoporosis Foundation called buildbetterbones.org. And the only three topics that they discuss there are exercise, home safety, and nutrition.

[chuckles] And the nutrition is a, a joy to read.

The whole website is, is, is wonderful.

And there are online calculators.

The International Osteoporosis Foundation has a really good calculator where someone can sort of plug in what they're eating in a day to get that, um, estimate, or I just do it the rough way with-

Yeah

... approximately 300 or 150, depending on what they're taking.

Hanne is a specialist in nephrology and associate professor at Aarhus University in Denmark, where she cares for patients across the full CKD spectrum and leads a research group focused on mineral metabolism and bone disease.

She is co-chair of the European Renal Osteodystrophy Initiative, the EROD, and was part of the steering committee for the 2033 Cadego Controversies Conference on CKD-MBD and sits on the scientific advisory board of the International Osteoporosis Foundation.

So if there is someone who can bridge the gap between the bone clinic and the dialysis unit, it's Hane.

Hane, welcome to A Pinch of Salt.