Review Article

A Roadmap to the Brittle Bones of Cystic Fibrosis

Table 2

Cystic fibrosis foundation guidelines for treatment of osteoporosis.

General Recommendations

Vitamin D goal25OH Vit D level >75 nmol/L or 30 ng/mL

Calcium1300–1500mg/day

Vitamin K0.3–0.5 mg/day

Target BMI>50th percentile
BMI adult females 23
BMI adult males 22

ExerciseEncourage outdoor and weight bearing exercise

InfectionsAggressive treatment of pulmonary infections

Specific Recommendations by T/Z Score

T/Z score ≤ −2−1≤ T/Z score ≤ −2T/Z scores ≥ −1.0

Repeat DEXAAnnualRepeated every 2–4 yearsRepeated every 5 years

SteroidMinimize steroid dosesNo recommendation

Endocrine Recognize and treat CF related diabetes, delayed puberty, hypogonadism, and consider endocrine consultNo recommendation

BisphosphonateStart bisphosphonateIf fragility fracture, patient awaiting transplant or accelerated BMD loss >3-5% per year start bisphosphonateNo recommendation