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Nutrition in Clinical Practice
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Invited Review

A Review of the Relationship Between Parenteral Nutrition and Metabolic Bone Disease

Marcus Ferrone, PharmD, BCNSP*
Matthew Geraci, PharmD{dagger}

* University of California, San Francisco, San Francisco, California; and {dagger} Mayo Clinic, Jacksonville, Florida

Correspondence: Correspondence: Marcus Ferrone, University of California, San Francisco, Drug Product Services Laboratory, 3333 California Street, Suite 420, San Francisco, CA 94118. Electronic mail may be sent to ferronem{at}pharmacy.ucsf.edu.

Metabolic bone disease (MBD) refers to the conditions that produce a diffuse decrease in bone density and strength because of an imbalance between bone resorption and bone formation. MBD can be a potential complication in patients receiving chronic parenteral nutrition (PN) therapy and the management of this condition presents a challenge for many clinicians. The etiology of PN-associated MBD is poorly understood, but traditional risk factors can include malnutrition, vitamin and mineral deficiencies, toxic contaminants in the PN solution, concomitant medications, and presence of certain disease states. Although additional studies are warranted to further elucidate the development and management of this condition, the following review discusses some of the important factors that may play a role in the genesis of PN-associated MBD and evaluates some potential strategies for the diagnosis and treatment of this complication.

Nutrition in Clinical Practice, Vol. 22, No. 3, 329-339 (2007)
DOI: 10.1177/0115426507022003329


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