Treatment of Adynamic Bone Disorder With Parathyroid Hormone in Chronic Kidney Disease

Exclusion Criteria

• •Hypercalcemia defined as sustained ionized calcium \>1.35 mmol/l
• •Previous fracture withon the last 6 months \*Patients may be rescreened after the 6 months
• •Previous calciphylaxis
• •Thyroid disturbances not adequately treated based on the opinion by the clinician \*Patients may be rescreened after treatment optimization
• •Treatment with digoxin
• •Paget's disease or other metabolic bone disorders
• •Antiresorptive or bone anabolic medication during the last 24 months (for bisphosphonates it is only during the last 12 months)
• •Former or present malignant disease (except skin basal or planocellular carcinoma)
• •Previous external beam or implant radiation therapy to the skeleton
• •Patients who have undergone a kidney transplantation within the last 12 months
• •25 hydroxyvitamin D2 and D3 \<50 nmol/l \*Patients may be rescreened after correction
• •Inability to administer teriparatide
• •Reduced liver function \*Alanine Aminotransferase (ALAT) \>3x upper limit of normal or bilirubin \> 2x upper limit of normal
• •Pregnancy, lactation or fertile women (post-menopausal females are not considered fertile) not using safe anticonception (the following contraceptive methods are considered appropriate: Intrauterine device (IUD) or hormonal anticontraceptive (oral contraceptives, implant, transdermal patches, vaginal ring or depot injection)).
• •Hypersensitivity to the active substance in teriparatide or to any of the excipients or content
• •Inability to provide informed consent
• •Medical conditions or treatments that may interfere with assessments of the outcomes of the trial
• •Drug or alcohol abuse
• •Unable to participate in a clinical study based on the judgement by the local investigator
• •For those participating in the bone biopsy procedure: 1) Hypersensitivity to any of the tetracyclines or to any of the excipients or content, 2) Treatment with anticoagulants (vitamin K antagonists, Non-vitamin K Antagonist Oral Anticoagulants (NOAC), unfractionated or low-molecular heparin or antiplatelet agents that, due to clinical indication can't be paused, 3) Disturbances in thrombosis and/or haemostasis
• •For those participating in pulse wave measurements: 1) Atrial fibrillation, 2) Aorta stenosis