Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure

Rix, Marianne; Andreassen, Helle Frost; Eskildsen, Peter Claes; Langdahl, Bente; Ølgaard, Klaus

doi:10.1046/j.1523-1755.1999.00617.x

Cited by 274 publications

(192 citation statements)

References 46 publications

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“…BMD measurements, as measured by DXA, may be low, normal, or high in any form of ROD. Although CKD is highly co-prevalent with osteoporosis as measured by DXA (5), low DXA measurements may not signify osteoporosis in the setting of significant CKD (27,28). Standard therapies for osteoporosis often include calcium supplementation and bisphosphonates; both may be detrimental to patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

“…The referent category of kidney function in the categorical models was an eGFR Ͼ60 ml/min. We chose this level as the referent a priori because kidney disease complications typically begin after the GFR has decreased to Ͻ60% of normal, and kidney biopsy series have indicated that kidneyrelated bone disease is apparent at mild levels of kidney dysfunction (27,28).…”

Section: Statistical Analysesmentioning

confidence: 99%

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Relationship between Moderate to Severe Kidney Disease and Hip Fracture in the United States

Nickolas

McMahon

Shane

2006

Journal of the American Society of Nephrology

345

227

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People with ESRD are at a high risk for hip fracture. However, the effect of moderate to severe chronic kidney disease (CKD) on hip fracture risk has not been well studied. As part of the Third National Health and Nutrition Examination Survey, information on both kidney function and history of hip fracture was obtained. This survey is a complex, multistage, probability sample of the US noninstitutionalized civilian population and was conducted between 1988 and 1994. A history of hip fracture was identified from the response to a questionnaire that was administered to all participants. There were 159 cases of hip fracture. There was a significantly increased likelihood of reporting a hip fracture in participants with estimated GFR <60 ml/min (odds ratio [OR] 2.12; 95% confidence interval [CI] 1.18 to 3.80). In younger participants (aged 50 to 74 yr), the prevalence of CKD was approximately three-fold higher in those with a history of hip fracture versus in those without a history of hip fracture (19.0 versus 6.2%, respectively; P ‫؍‬ 0.04). In multivariate logistic regression analysis, only the presence of CKD (OR 2.32; 95% CI 1.13 to 4.74), a reported history of osteoporosis (OR 2.52; 95% CI 1.08 to 5.91), and low physical activity levels (OR 2.10; 95% CI 1.03 to 4.27) were associated with a history of hip fracture. There is a significant association between hip fracture and moderate to severe degrees of CKD, particularly in younger individuals, that is independent of traditional risk factors for hip fracture.

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Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Relationship between Moderate to Severe Kidney Disease and Hip Fracture in the United States

Nickolas

McMahon

Shane

2006

Journal of the American Society of Nephrology

345

227

View full text Add to dashboard Cite

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“…The few prospective trials assessing the fracture prediction characteristics of DXA in CKD-mineral and bone disorder (CKD-MBD) patients are also inconsistent (9)(10)(11). Moreover, the spectrum of bone turnover and mineralization abnormalities that characterize renal osteodystrophy may be associated with low, normal, or high BMD (7,12,13). For these reasons, the 2009 Kidney Disease Improving Global Outcomes (KDIGO) Guidelines consensus statement on fracture risk assessment in CKD-MBD does not recommend using aBMD by DXA to screen patients for osteoporosis or to predict fracture risk (14).…”

mentioning

confidence: 99%

BMD and Fracture Risk in CKD

Nickolas

2012

Clinical Journal of the American Society of Nephrology

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“…Although severe osteodystrophy is less common in earlier stages of CKD, elevated intact parathyroid hormone (iPTH) levels, considered one of the earliest markers of abnormal bone mineral metabolism in CKD, have been reported frequently in clinic-based studies of patients with renal insufficiency (3)(4)(5)(6)(7)(8)(9)(10). Also, even moderate reductions in renal function have been associated with significant increases in the risk of hip fracture (11,12).…”

mentioning

confidence: 99%

Association of Serum Intact Parathyroid Hormone with Lower Estimated Glomerular Filtration Rate

Muntner¹,

Jones²,

Hyre³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Results: The geometric mean iPTH level was 39.3 pg/ml. The age-standardized prevalence of elevated iPTH was 8.2%, 19.3%, and 38.3% for participants with eGFR > 60, 45 to 59, and 30 to 44 ml/min/1.73 m 2 , respectively (P-trend < 0.001). After adjustment for age; race/ethnicity; sex; menopausal status; education; income; cigarette smoking; alcohol consumption; body mass index; hypertension; diabetes mellitus; vitamin D supplement use; total calorie and calcium intake; and serum calcium, phosphorus, and 25-hydroxyvitamin D levels-and compared with their counterparts with an eGFR > 60 ml/min/1.73 m 2 -the prevalence ratios of elevated iPTH were 2.30 and 4.69 for participants with an eGFR of 45 to 59 and 30 to 44 ml/min/1.73 m 2 , respectively (P-trend < 0.001). Serum phosphorus > 4.2 mg/dl and 25-hydroxyvitamin D < 17.6 ng/ml were more common at lower eGFR levels. No association was present between lower eGFR and serum calcium < 9.4 mg/dl.Conclusions: This study indicates that elevated iPTH levels are common among patients with moderate CKD.

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Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure

Abstract: Skeletal changes are initiated at an early stage of chronic renal failure, as estimated from reduced BMD and elevated levels of PTH and from the biochemical markers of both bone formation and bone resorption.

Cited by 274 publications

References 46 publications

Relationship between Moderate to Severe Kidney Disease and Hip Fracture in the United States

Relationship between Moderate to Severe Kidney Disease and Hip Fracture in the United States

BMD and Fracture Risk in CKD

Association of Serum Intact Parathyroid Hormone with Lower Estimated Glomerular Filtration Rate

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