Circulating levels of osteoprotegerin and receptor activator of NF-κB ligand in patients with chronic renal failure

Shaarawy, Mohamed; Fathy, Shadia A.; Mehany, N. L.; Hindy, Odette W

doi:10.1515/cclm.2007.306

Cited by 20 publications

(13 citation statements)

References 30 publications

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“…OPG concentrations are reported to be higher in HD patients [35][36][37][38][39], whereas RANKL level can be higher [39,40], lower [36] or within normal range [41] compared to healthy individuals. Kazama showed that serum OPG levels in uremic patients were elevated and independent of their serum PTH levels, what suggested the circulating OPG to be an independent factor affecting bone metabolism in uremic patients [42].…”

Section: Opg/rank/rankl System In Esrdmentioning

confidence: 98%

OPG/RANK/RANKL signaling system and its significance in nephrology.

Klejna

Naumnik²,

Gasowska³

et al. 2009

Folia Histochem Cytobiol.

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Section: Opg/rank/rankl System In Esrdmentioning

confidence: 98%

OPG/RANK/RANKL signaling system and its significance in nephrology.

Klejna

Naumnik²,

Gasowska³

et al. 2009

Folia Histochem Cytobiol.

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“…In humans, the OPG/RANKL system has been mainly studied in adults with end-stage CKD [11,12]. In childhood, the interpretation of bone mineral measurements is more complex than in adults because of more dynamic changes in growing bones.…”

Section: Abbreviationsmentioning

confidence: 99%

Serum osteoprotegerin, RANKL and fibroblast growth factor-23 in children with chronic kidney disease

et al. 2011

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Osteoprotegerin (OPG), receptor activator of the nuclear factor κB ligand (RANKL) and fibroblast growth factor-23 (FGF-23) play a central role in renal osteodystrophy. We evaluated OPG/RANKL and FGF-23 levels in 51 children with chronic kidney disease (CKD) [n = 26 stage 3 or 4 (CKD3-4) and n = 25 stage 5 (CKD5)] and 61 controls. Any possible association with intact parathyroid hormone (iPTH) and bone turnover markers was also investigated. The OPG levels were lower in the CKD3-4 group (p < 0.001) and higher in the CKD5 group (p < 0.01) than in the controls, while RANKL levels did not differ. The FGF-23 levels were higher in both patient groups (p < 0.0001), while the levels of phosphate and iPTH were higher only in the CKD5 group (p < 0.0001). There were independent positive correlations between OPG and RANKL (β = 0.297, p < 0.01) and FGF-23 (β = 0.352, p < 0.05) and a negative correlation with the bone resorption marker TRAP5b (β = -0.519, p < 0.001). OPG was positively correlated with iPTH (R = 0.391, p < 0.01). An independent positive correlation between FGF-23 and phosphate (β = 0.368, p < 0.05) or iPTH (β = 0.812, p < 0.0001) was noted. In conclusion, we found that higher OPG levels in patients with CKD stage 5 correlated with the levels of RANKL, FGF-23, iPTH, and TRAP5b. These findings may reflect a compensatory mechanism to the negative balance of bone turnover. High FGF-23 levels in early CKD stages may indicate the need for intervention to manage serum phosphate (Pi) levels.

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“…Several authors [55,72,73] reported high OPG levels in patients on dialysis, but the regulation and function of circulating OPG in kidney failure is not known.…”

Section: The Role Of Osteoprotegerin In Regulation Of Bone Mineralizamentioning

confidence: 99%

Bone mineral density in patients on maintenance dialysis

et al. 2009

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Disorders of bone and mineral metabolism affect almost all patients with advanced chronic kidney disease (CKD). High prevalence of decreased bone mineral density has been reported in this population; however, the role and diagnostic utility of bone density measurements are not well established. The incidence of bone fractures is high in patients with ESRD, but the association between fractures and bone density is not obvious. A recent meta-analysis suggested that decreased density at the radius might be associated with higher overall fracture risk. Changes in bone mineral density reflect several underlying pathological processes, such as vitamin D deficiency, estrogen deficiency and changes in bone turnover. The response of bone to these factors and processes is not uniform: it can vary in different compartments of the same bone or in different bones of the skeleton. Therefore, it is important to differentiate between the various types of bone. This may be possible by proper selection of the measurement site or using methods such as quantitative bone computed tomography. Previous studies used different methods and measured bone mineral density at diverse sites of the skeleton, which makes the comparison of their results very difficult. The association between changes in bone mineral metabolism and cardiovascular mortality is well known in ESRD patients. Studies also suggest that low bone density itself might be an indicator for high risk of cardiovascular events and poor overall outcome in this population. Some of the risk factors of low bone mineral density, such as vitamin D or estrogen deficiency, are potentially modifiable. Further studies are needed to elucidate if interventions modifying these risk factors will have an impact on clinical outcomes. In this review, we discuss the options for and problems of assessment of bone density and summarize the literature about factors associated with low bone density and its link to clinical outcomes in patients on maintenance dialysis.

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Circulating levels of osteoprotegerin and receptor activator of NF-κB ligand in patients with chronic renal failure

Abstract: The OPG-RANKL system is involved in the pathogenesis and regulation of bone turnover in CRF. Circulating levels of OPG and RANKL may be useful markers to assess turnover renal osteopathies.

Cited by 20 publications

References 30 publications

OPG/RANK/RANKL signaling system and its significance in nephrology.

OPG/RANK/RANKL signaling system and its significance in nephrology.

Serum osteoprotegerin, RANKL and fibroblast growth factor-23 in children with chronic kidney disease

Bone mineral density in patients on maintenance dialysis

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