Review article: Bone density in patients with chronic kidney disease stages 4‐5

Ott, Susan M.

doi:10.1111/j.1440-1797.2009.01159.x

Cited by 57 publications

(30 citation statements)

References 93 publications

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“…Ott 15 has examined the results from studies that measure BMD and serum PTH in CKD patients and has observed that none of these studies found a positive relationship between PTH and BMD; either the relationship was not significant or there was a significant inverse correlation. Similarly, we also did not find an association between BMD and apelin.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Apelin and Parathyroid Hormone in Hemodialysis Patients

Mafra

Lobo

Farage³

et al. 2012

Renal Failure

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Both apelin and parathyroid hormone (PTH) are endogenous ligands for G-protein-coupled receptors. Apelin acts as a mitogenic agent for osteoblasts, and metabolic bone abnormalities are frequently seen in hemodialysis (HD) patients because of hyperparathyroidism. The aim of this study was to analyze plasma apelin levels in HD patients and to determine whether they are related to PTH concentrations. A total of 23 HD patients [15 men and 8 women, with a mean (SD) age of 54.2 (4.4) years and a mean body mass index (BMI) of 25.0 (4.1) kg/m 2 ] were studied and compared with 15 healthy subjects [6 men and 9 women, with a mean (SD) age of 51.3 (13.6) years and a BMI of 27.0 (4.3) kg/m 2 ]. Plasma apelin-36 was measured using an enzyme immunometric assay method and PTH was measured by ELISA. There was no significant difference in apelin levels between the patients [0.80 (0.6) ng/mL] and the healthy subjects [0.83 (0.23) ng/mL]. There was a positive correlation between apelin and PTH (r ¼ 0.66, p ¼ 0.0001). The patients with PTH >300 pg/mL had significantly higher plasma apelin levels [1.17 (0.7) ng/mL] compared with the patients with PTH <300 pg/mL [0.50 (0.15) ng/mL] (p ¼ 0.003). In conclusion, HD patients with secondary hyperparathyroidism have high plasma apelin levels, which suggest that apelin may protect bone in HD patients by acting as an osteoblastic factor.

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Section: Discussionmentioning

confidence: 99%

The Relationship between Apelin and Parathyroid Hormone in Hemodialysis Patients

Mafra

Lobo

Farage³

et al. 2012

Renal Failure

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“…Whereas some patients have a minimal bone loss, others show rapid bone losses 86. Additionally, the presence of aorta calcification and spinal osteoarthritis may bias BMD measurement,88 being the hip and the radius better sites for the BMD assessment. Interestingly, it has been shown in a population of 2754 elderly subjects, including 587 subjects with CKD, that lower BMD was a risk factor associated with skeletal fractures 89.…”

Section: Bone and Musculoskeletal Abnormalities In Chronic Kidney Dismentioning

confidence: 99%

Vitamin D, a modulator of musculoskeletal health in chronic kidney disease

Molina

Carrero

Bover

et al. 2017

J cachexia sarcopenia muscle

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The spectrum of activity of vitamin D goes beyond calcium and bone homeostasis, and growing evidence suggests that vitamin D contributes to maintain musculoskeletal health in healthy subjects as well as in patients with chronic kidney disease (CKD), who display the combination of bone metabolism disorder, muscle wasting, and weakness. Here, we review how vitamin D represents a pathway in which bone and muscle may interact. In vitro studies have confirmed that the vitamin D receptor is present on muscle, describing the mechanisms whereby vitamin D directly affects skeletal muscle. These include genomic and non‐genomic (rapid) effects, regulating cellular differentiation and proliferation. Observational studies have shown that circulating 25‐hydroxyvitamin D levels correlate with the clinical symptoms and muscle morphological changes observed in CKD patients. Vitamin D deficiency has been linked to low bone formation rate and bone mineral density, with an increased risk of skeletal fractures. The impact of low vitamin D status on skeletal muscle may also affect muscle metabolic pathways, including its sensitivity to insulin. Although some interventional studies have shown that vitamin D may improve physical performance and protect against the development of histological and radiological signs of hyperparathyroidism, evidence is still insufficient to draw definitive conclusions.

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“…Any calcium in the path of the X-ray beam will contribute to the BMD measurement (degenerative disc disease, osteophytes, osteoarthritis with hyperostosis, aortic calcifications, etc.) and cause false elevation 3,[16][17][18] . Lower BMD and higher prevalence of T-score values corresponding to osteoporosis in females in this study are consistent with data in the general population 19,20 .…”

Section: Both Gender Females Malesmentioning

confidence: 99%

Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

Valkovský¹,

R²,

Tvrdík³

et al. 2015

BIOMED PAP

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Background. Patients with chronic kidney disease (CKD) have significant disorders of bone and mineral metabolism. In addition, they can also develop other bone disorders including osteoporosis. This study evaluated the bone mineral density (BMD) of patients at the start of hemodialysis treatment as well as the relationship between BMD and possible risk factors or biochemical markers. Methods. The study was performed in 82 patients (28 females, 54 males). BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and the proximal femur. Results. We found a high prevalence of 25-hydroxyvitamin D deficiency (96%; mean levels 30.0 ± 17.7 nmol/L) and a reduction of BMD in comparison with gender-and age-matched normal population values at the total hip (Z-score = -0.31 ± 1.11) and the femoral neck (Z-score = -0.48 ± 1.16), but not at the lumbar spine (Z-score = 0.68 ± 1.81). The prevalence of T-scores ≤ -2.5 SD in the group of patients over 50 years was 52.0% in females and 33.3% in males. BMD positively correlated: with male gender and calcium levels at all measured sites, with age at the lumbar spine and with weight or BMI at the proximal femur. Conclusion. CKD patients at the start of hemodialysis treatment had a high prevalence of low T-score values, corresponding to values for osteoporosis in the general population. BMD at the proximal femur was below the expected average for age and gender, but at the lumbar spine, BMD in hemodialysis patients was above average in persons without known CKD.

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Review article: Bone density in patients with chronic kidney disease stages 4‐5

Cited by 57 publications

References 93 publications

The Relationship between Apelin and Parathyroid Hormone in Hemodialysis Patients

The Relationship between Apelin and Parathyroid Hormone in Hemodialysis Patients

Vitamin D, a modulator of musculoskeletal health in chronic kidney disease

Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

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