Hepatic osteodystrophy

Hepatic osteodystrophy is an often forgotten metabolic bone disease seen in patients with chronic liver disease, in particular cirrhosis, primary biliary cholangitis, and primary sclerosing cholangitis.

Cirrhotic patients have increased risk factors for developing osteoporosis such as hypogonadism, alcohol and steroid use, vitamin D deficiency, and low body mass index. Other factors that contribute include poor intestinal cholecalciferol absorption, impaired vitamin D activation and hyperbilirubinemia which can diminish osteoblastic function ⁴.