Role of Calcium, Vitamin D and Bisphosphonates in the Treatment of Osteoporosis in patients with Cirrhosis

Abstract

Osteoporosis is a significant and prevalent consequence of cirrhosis due to its detrimental influence on quality of life through persistent pain and immobility. Additionally, its significant morbidity necessitates early detection and treatment. BD is most frequently encountered in the elderly, smokers, postmenopausal women, alcoholics, malnourished individuals, and those with cholestatic liver disease. The prevalence of osteoporosis has been observed to range between 12--55% in patients with cirrhosis. Patients with primary biliary cirrhosis (PBC) have a higher prevalence due to persistent cholestasis and female gender. Prior to orthotopic liver transplantation, about 60% of cases with PBC and primary sclerosing cholangitis (PSC) have osteoporosis. It is critical to diagnose and treat osteoporosis prior to liver transplantation because of deterioration in early months i.e. 6—12 after transplantation. This resulted in much fractures due to trauma i.e. 25—35%. This osteoporosis may be due to toxic effect of immune compromised therapy after transplantation. Keywords: Role of calcium, cirrhosis, vitamin D