Bone loss in chronic kidney disease: Quantity or quality?

Zheng, Cai Mei; Zheng, Jin-Quan; Wu, Chia-Chao; Lu, Cheng Wei; Shyu, Jia‐Fwu; Yung-Ho, Hsu; Wu, Mei‐Yi; Chiu, I‐Jen; Wang, Yuan–Hung; Lin, Yuh‐Feng; Lu, Kuo‐Cheng

doi:10.1016/j.bone.2016.03.017

Cited by 37 publications

(39 citation statements)

References 198 publications

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“…CKD patients are more susceptible to osteoporotic fractures and fracture‐related mortality because of the changes in their mineral metabolism and bone structure, which occur early in the course of the disease and worsen with the progressive loss of kidney function . CKD patients generally exhibit two broad pathways for bone fragility depending on the stage of renal impairment . Traditional osteoporosis as defined by the National Institutes of Health (NIH) is mostly seen in those with early CKD.…”

Section: Introductionmentioning

confidence: 99%

Oral Bisphosphonate Use and All-Cause Mortality in Patients With Moderate–Severe (Grade 3B-5D) Chronic Kidney Disease: A Population-Based Cohort Study

Alarkawi

Ali

Bliuc

et al. 2020

Journal of Bone and Mineral Research

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Oral bisphosphonates (oBPs) have been associated with reduced fractures and mortality. However, their risks and benefits are unclear in patients with moderate-severe CKD. This study examined the association between oBPs and all-cause mortality in G3B-5D CKD. This is a population-based cohort study including all subjects with an estimated glomerular filtration rate (eGFR) <45/mL/ min/1.73 m 2 (G3B: eGFR <45/mL/min/1.73 m 2 G4: eGFR 15-29/mL/min/1.73 m 2 G5: eGFR <15/mL/min/1.73 m 2 G5D: hemodialysis) aged 40+ years from the UK Clinical Practice Research Datalink (CPRD) and the Catalan Information System for Research in Primary Care (SIDIAP). Previous and current users of other anti-osteoporosis drugs were excluded. oBP use was modeled as a time-varying exposure to avoid immortal time bias. Treatment episodes in oBP users were created by concatenating prescriptions until patients switched or stopped therapy or were censored or died. A washout period of 180 days was added to (date of last prescription +180 days). Propensity scores (PSs) were calculated using prespecified predictors of mortality including age, gender, baseline eGFR, socioeconomic status, comorbidities, previous fracture, co-medications, and number of hospital admissions in the previous year. Cox models were used for PS adjustment before and after PS trimming (the first and last quintiles). In the CPRD, of 19,351 oBP users and 210,954 non-oBP users, 5234 (27%) and 85,105 (40%) deaths were recorded over 45,690 and 915,867 person-years of follow-up, respectively. oBP users had 8% lower mortality risk compared to non-oBP users (hazard ratio [HR] 0.92; 95% CI, 0.89 to 0.95). Following PS trimming, this became nonsignificant (HR 0.98; 95% CI, 0.94 to 1.04). In the SIDIAP, of 4146 oBP users and 86,127 non-oBP users, 1330 (32%) and 36,513 (42%) died, respectively. oBPs were not associated with mortality in PS adjustment and trimming (HR 1.04; 95% CI, 0.99 to 1.1 and HR 0.95; 95% CI, 0.89 to 1.01). In this observational, patient-based cohort study, oBPs were not associated with increased mortality among patients with moderate-severe CKD. However, further studies are needed on other effects of oBPs in CKD patients.

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Section: Introductionmentioning

confidence: 99%

Oral Bisphosphonate Use and All-Cause Mortality in Patients With Moderate–Severe (Grade 3B-5D) Chronic Kidney Disease: A Population-Based Cohort Study

Alarkawi

Ali

Bliuc

et al. 2020

Journal of Bone and Mineral Research

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“…In this process of "osteo-chondrocyte transdifferentiation" different factors involved in the differentiation of bone cells, such as Runx2, bone morphogenic proteins (BMPs), RANK/RANKL/OPG system or Wnt pathway would intervene. Furthermore, in patients with CKF and in animal models of this disease, increased vascular calcification is accompanied by a reduction in bone mass, suggesting that the signals involved in bone and vascular wall mineralization may behave differently depending on the tissue microenvironment in which they act 6,7 . CKF is characterized by changes in bone metabolism that, in addition to being detrimental to the skeleton -renal osteodystrophy-favor calcification of soft tissues and vessels.…”

mentioning

confidence: 99%

“…CKF is characterized by changes in bone metabolism that, in addition to being detrimental to the skeleton -renal osteodystrophy-favor calcification of soft tissues and vessels. Hypercalcemia and hyperphosphatemia, hyperparathyroidism, increased fibroblast growth factor 23 (FGF23), increased oxidative stress and decreased inhibitors of calcification such as fetuin-A and pyrophosphates could all play a role in the vascular calcification process 1,2,6,7 . Hyperphosphatemia, as well as hypercalcemia, are two of the main factors associated with the development of vascular calcification in CRF 8 .…”

mentioning

confidence: 99%

Insuficiencia renal crónica, calcificación vascular y sistema RNK/RANKL/OPG

Olmos

Hernández

2016

Rev Osteoporos Metab Miner

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“…High turnover bone disease results from PTH levels higher than 400 pg/mL, which induces osteoclastogenesis and a compensatory osteoblastogenesis. Yet there is also inhibition of osteoblast function and stimulation of osteoblast apoptosis with the end product of bone resorption [14, 20]. …”

mentioning

confidence: 99%

“…The cortical bone suffers a decrease in its thickness, whereas trabecular bone thickness increases but has lower quality, signifying reduced trabecular connectivity and increased trabecular perforations [20]. …”

mentioning

confidence: 99%

Brachyonychia Associated with Acroosteolysis in Chronic Kidney Disease: How Phalange Shape Influences Nail Morphology

Figueroa¹,

Chang

2018

Skin Appendage Disord

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Brachyonychia is a rare manifestation in patients with chronic kidney disease. Longtime disease, secondary hyperparathyroidism, and hemodialysis are common conditions among those who present it. We evaluated 8 cases who presented brachyonychia in the nephrology department and compared the clinical versus the radiographic findings, and evaluated how the tissue adjusts to the underlying bone structure, giving different forms to the nails. We conclude that brachyonychia and acroosteolysis in chronic kidney disease suggest long-term disease, secondary hyperparathyroidism, and hemodialysis, besides it being a good model on how the bony structure defines the soft tissue morphology.

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Bone loss in chronic kidney disease: Quantity or quality?

Cited by 37 publications

References 198 publications

Oral Bisphosphonate Use and All-Cause Mortality in Patients With Moderate–Severe (Grade 3B-5D) Chronic Kidney Disease: A Population-Based Cohort Study

Oral Bisphosphonate Use and All-Cause Mortality in Patients With Moderate–Severe (Grade 3B-5D) Chronic Kidney Disease: A Population-Based Cohort Study

Insuficiencia renal crónica, calcificación vascular y sistema RNK/RANKL/OPG

Brachyonychia Associated with Acroosteolysis in Chronic Kidney Disease: How Phalange Shape Influences Nail Morphology

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