Kidney Disease and Bone: Changing the Way We Look at Skeletal Health

Allen, Matthew R.; Swallow, Elizabeth A.; Metzger, Corinne E.

doi:10.1007/s11914-020-00580-9

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Nevertheless, we should not assume that more severe CKD necessarily corresponds to greater PI values, because the actual mechanism by which CKD drives cortical pore enlargement is still largely unknown (32). The factors leading to bone deterioration in patients with CKD are very complex and include the severity of hyperparathyroidism, the level of various bone metabolism markers, the degree of bone turnover and the impact of CKD itself on the bones, and these factors are interrelated (33)(34)(35). Consequently, we further conducted an exploratory mediation analysis.…”

Section: Discussionmentioning

confidence: 99%

CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis

Xiong

Wang

et al. 2021

Front. Endocrinol.

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Chronic kidney disease (CKD) has a significant negative impact on bone health. However, the mechanisms of cortical bone deterioration and cortical porosity enlargement caused by CKD have not been fully described. We therefore examined the association of CKD stages with cortical porosity index (PI), and explored potential mediators of this association. Double-echo ultrashort echo-time magnetic resonance imaging (UTE MRI) provides the possibility of quantifying cortical porosity in vivo. A total of 95 patients with CKD stages 2-5 underwent 3D double-echo UTE-Cones MRI (3.0T) of the midshaft tibia to obtain the PI. PI was defined as the ratio of the image signal intensity of a sufficiently long echo time (TE) to the shortest achievable TE. Parathyroid hormone (PTH), β-CrossLaps (β-CTX), total procollagen type I amino-terminal propeptide (T-P1NP), osteocalcin (OC), 25-hydroxyvitamin D (25OHD), and lumbar bone mineral density (BMD) were measured within one week of the MRI. Partial correlation analysis was performed to address associations between PI, eGFR and potential mediators (PTH, β-CTX, T-P1NP, OC, 25OHD, BMD, and T-score). Multiple linear regression models were used to assess the association between CKD stages and PI value. Then, a separate exploratory mediation analysis was carried out to explore the impact of CKD stages and mediators on the PI value. The increasing CKD stages were associated with a higher PI value (Ptrend < 0.001). The association of CKD stages and PI mediated 34.4% and 30.8% of the total effect by increased PTH and β-CTX, respectively. Our study provides a new idea to monitor bone health in patients with CKD, and reveals the internal mechanism of bone deterioration caused by CKD to some extent.

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Section: Discussionmentioning

confidence: 99%

CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis

Xiong

Wang

et al. 2021

Front. Endocrinol.

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“…This condition initially emerges early as CKD, often when the glomerular filtration rate falls below 60 ml/min. Its severity increases with worsening renal function due to progressive phosphate retention, reduced calcitriol levels, and hypocalcemia [5,6].…”

Section: Introductionmentioning

confidence: 99%

Case Report on Brown Tumor: An Unusual Expression of Renal Osteodystrophy and Secondary Hyperparathyroidism

Krishna,

Nair,

K F

et al. 2024

IJMPCR

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The new term of ‘Chronic Kidney Disease- Mineral and Bone Disorders’ has been introduced to encompass a wide-ranging syndrome, capturing various abnormalities in bone and mineral metabolism seen in patients with chronic kidney disease. Multifactorial disorders affecting mineral metabolism and bone structure emerge early in the progression of Chronic Kidney Disease. Brown tumors, an uncommon type of bone lesion are distinctive manifestations of high-turnover bone disease. In this case, a patient with chronic kidney disease (dialysis dependent) with IgA nephropathy that presented with multiple osseous lesions of bilateral ribs, sternum, scapula, clavicle, mandible and vertebral bodies. The case highlights the significance of considering brown tumors in the differential diagnosis and management of patients with both an osseous mass and chronic kidney disease. Failing to establish an accurate diagnosis may result in unnecessary additional diagnostic procedures and extensive surgery, ultimately increasing patient morbidity. Through this case report, the importance of preventing, early diagnosing, and treating secondary hyperparathyroidism to reduce the prevalence of high-turnover bone disease and associated complications such as brown tumors is emphasized.

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Prise en charge de l’ostéoporose au cours de la maladie rénale chronique

Lafage-Proust

2024

Revue du Rhumatisme

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Kidney Disease and Bone: Changing the Way We Look at Skeletal Health

Cited by 4 publications

References 19 publications

CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis

CKD Stages, Bone Metabolism Markers, and Cortical Porosity Index: Associations and Mediation Effects Analysis

Case Report on Brown Tumor: An Unusual Expression of Renal Osteodystrophy and Secondary Hyperparathyroidism

Prise en charge de l’ostéoporose au cours de la maladie rénale chronique

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