Osteoporosis en pacientes con hepatopatías crónicas: una complicación tardía poco conocida Osteoporosis in patients with chronic liver disease: An unfamiliar late complication

Hepatic osteodystrophy is a frequent late complication in chronic liver diseases in which patients usually pre- sent bone mineral density reduction, osteopenia, osteoporosis and fractures. Strategies to decrease inciden- ce, avoid comorbidity and improve patient quality of life have yet to be implemented in clinical practice. Hepatic osteodystrophy's pathophysiology is poorly understood. There is controversy about the use of screening tests especially regarding which patients are eligible, at what moment of the disease and with what frequency. Risk factors which are dependent on liver disease and other risk factors which are not liver disease dependent have been identifi ed, all of which affect the natural history of hepatic osteodystrophy and all of which must be taken into account for screening, checkups and treatment. Recommendations for treatment are widely discussed but focus mainly on reduction of risk factors, antiresorptive drugs, calcium supplements and vitamin D.