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renal osteodystrophy

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https://www.readbyqxmd.com/read/28429557/use-of-dual-energy-x-ray-absorptiometry-the-trabecular-bone-score-and-quantitative-computed-tomography-in-the-evaluation-of-chronic-kidney-disease-mineral-and-bone-disorders
#1
Nicholas Pocock
In subjects with chronic kidney disease (CKD) who suffer a minimal trauma fracture, the problem is to differentiate between osteoporosis and the various forms of renal bone disease associated with CKD-mineral and bone disorder. This problem is exacerbated by the fact that renal osteodystrophy may coexist with osteoporosis. The World Health Organization's bone mineral density (BMD) criteria for osteopenia ( -2.5 < T-score < -1.0) and osteoporosis (a T-score ≤ -2.5) may be used in patients with CKD stages 1-3...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429554/is-there-a-practical-role-for-bone-biopsy-in-chronic-kidney-disease
#2
Terrence Diamond, Grahame J Elder
Bone biopsy is currently the only means to accurately assess renal osteodystrophy and responses to therapeutic interventions. With sedation, the technique is relatively painless, and complications are uncommon. Bone biopsy should be considered when the aetiology of symptoms or biochemical abnormalities is in question, and results may lead to changes in therapy. Although it remains prudent to use antiresorptive drugs cautiously in patients with chronic kidney disease (CKD) stages 3a-4 and low bone mineral density, bone biopsy may not be warranted before commencing therapy in these patients...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429549/is-there-a-practical-role-for-a-virtual-bone-biopsy-using-high-resolution-imaging-of-bone-in-patients-with-chronic-kidney-disease
#3
Ashish K Sharma, Nigel D Toussaint
Renal osteodystrophy (ROD) refers to alterations in bone turnover, mineralisation, mass and microarchitecture in patients with chronic kidney disease (CKD) and represents the skeletal component of 'CKD-mineral and bone disorder'. Changes in bone structure lead to impaired bone quality, compromised bone strength and increased susceptibility to fractures with associated significant morbidity, mortality and financial cost. Diagnosis and management of ROD is hindered by the inadequacy of currently available diagnostic methods to interpret the complex pathophysiology...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429545/do-the-benefits-of-using-calcitriol-and-other-vitamin-d-receptor-activators-in-patients-with-chronic-kidney-disease-outweigh-the-harms
#4
Nigel D Toussaint, Matthew J Damasiewicz
The primary indication for administration of calcitriol or other vitamin D receptor activators (VDRA) in chronic kidney disease (CKD) is secondary hyperparathyroidism (SHPT). Prevention and treatment of SHPT appears important, as imbalances in mineral metabolism are associated with renal osteodystrophy, and higher parathyroid hormone (PTH) levels are associated with increased rates of mortality and morbidity in CKD patients. There is, however, a lack of controlled trial data that show lowering PTH with calcitriol/VDRA equates to improved clinical outcomes...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28405928/adynamic-bone-disease-is-a-predominant-bone-pattern-in-early-stages-of-chronic-kidney-disease
#5
REVIEW
Ziad Massy, Tilman Drueke
Chronic kidney disease (CKD) is complicated by disturbances of mineral and bone metabolism which start early in the course of the disease. It has long been assumed that high turnover bone lesions induced by secondary hyperparathyroidism are the predominant type of renal osteodystrophy from the start. However, there is increasing evidence in favor of the view that in early CKD stages low bone turnover is prevailing, with adynamic bone disease being the predominant form. Since serum parathyroid hormone levels increase progressively early on, and the most probable explanation is resistance to the skeletal action of this hormone...
April 12, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28396120/klotho-expression-in-osteocytes-regulates-bone-metabolism-and-controls-bone-formation
#6
Hirotaka Komaba, Jovana Kaludjerovic, Dorothy Z Hu, Kenichi Nagano, Katsuhiko Amano, Noriko Ide, Tadatoshi Sato, Michael J Densmore, Jun-Ichi Hanai, Hannes Olauson, Teresita Bellido, Tobias E Larsson, Roland Baron, Beate Lanske
Osteocytes within the mineralized bone matrix control bone remodeling by regulating osteoblast and osteoclast activity. Osteocytes express the aging suppressor Klotho, but the functional role of this protein in skeletal homeostasis is unknown. Here we identify Klotho expression in osteocytes as a potent regulator of bone formation and bone mass. Targeted deletion of Klotho from osteocytes led to a striking increase in bone formation and bone volume coupled with enhanced osteoblast activity, in sharp contrast to what is observed in Klotho hypomorphic (kl/kl) mice...
April 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28339949/bone-biopsy-practice-patterns-across-europe-the-european-renal-osteodystrophy-initiative-a-position-paper
#7
Pieter Evenepoel, Patrick D'Haese, Justine Bacchetta, Jorge Cannata-Andia, Anibal Ferreira, Mathias Haarhaus, Sandro Mazzaferro, Marie-Helene Lafage Proust, Syazrah Salam, Goce Spasovski, Mario Cozzolino
Renal osteodystrophy (ROD) is a heterogeneous group of metabolic bone diseases complicating progressive chronic kidney disease (CKD). Bone biomarkers and bone imaging techniques may help to assess bone health and predict fractures in CKD but do have important inherent limitations. By informing on bone turnover and mineralization, a bone biopsy may help to guide prevention and treatment of ROD and its consequences. According to a recent survey conducted among European nephrologists, bone biopsies are performed rather exceptionally, both for clinical and research purposes...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28322468/effect-of-stage-based-education-provided-by-dedicated-dietitians-on-hyperphosphataemic-haemodialysis-patients-results-from-the-nutrition-education-for-management-of-osteodystrophy-randomised-controlled-trial
#8
R Rizk, M Karavetian, M Hiligsmann, S M A A Evers
BACKGROUND: The Nutrition Education for Management of Osteodystrophy trial showed that stage-based nutrition education by dedicated dietitians surpasses existing practices in Lebanon with respect to lowering serum phosphorus among general haemodialysis patients. The present study explores the effect of nutrition education specifically on hyperphosphataemic patients from this trial. METHODS: Hyperphosphataemic haemodialysis patients were allocated to a dedicated dietitian (DD), a trained hospital dietitian (THD) and existing practice (EP) protocols...
March 21, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28290186/phosphorus-and-other-aspects-of-ckd-mbd-in-the-conservative-management-of-chronic-kidney-disease
#9
Anuja Shah
As the prevalence of chronic kidney disease (CKD) increases and the population ages, there is an imperative to offer cost effective and patient specific therapeutic options for the management of advanced CKD. In cases where there is a desire to avoid or delay renal replacement therapy, conservative options need to be defined and strategies for delaying the need for renal replacement therapy should be offered. CKD-mineral bone disorders (MBD) refers to the constellation of disturbances in abnormal bone and soft tissue calcification along with abnormalities, in phosphorus, calcium, parathyroid hormone, vitamin D, and FGF-23...
June 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28286758/role-of-vitamin-d-in-uremic-vascular-calcification
#10
REVIEW
Yi-Chou Hou, Wen-Chih Liu, Cai-Mei Zheng, Jing-Quan Zheng, Tzung-Hai Yen, Kuo-Cheng Lu
The risk of cardiovascular death is 10 times higher in patients with CKD (chronic kidney disease) than in those without CKD. Vascular calcification, common in patients with CKD, is a predictor of cardiovascular mortality. Vitamin D deficiency, another complication of CKD, is associated with vascular calcification in patients with CKD. GFR decline, proteinuria, tubulointerstitial injury, and the therapeutic dose of active form vitamin D aggravate vitamin D deficiency and reduce its pleiotropic effect on the cardiovascular system...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28253186/brown-tumor-clinical-findings-of-secondary-hyperparathyroidism-in-patients-with-renal-osteodystrophy
#11
Mairaira Teles Leão E Silva, Juliana Silva Barros Cedraz, Caetano Guilherme Carvalho Pontes, Cleverson Luciano Trento, Bernardo Ferreira Brasileiro, Marta Rabello Piva, Fabiano Alvim Pereira
A brown tumor, or osteoclastoma, is a nonneoplastic bony lesion associated with hyperparathyroidism and directly related to increased levels of parathyroid hormone. These tumors result from excessive osteoclastic activity. This article presents 3 cases of brown tumor localized in facial bones. The lesions were the result of secondary hyperparathyroidism associated with chronic renal failure. The patients were two 42-year-old men and a 39-year-old woman. All patients had been treated systemically by hemodialysis for more than 10 years...
March 2017: General Dentistry
https://www.readbyqxmd.com/read/28194476/-diagnosis-and-treatment-of-chronic-kidney-disease
#12
M Girndt
Chronic kidney disease is defined by decreased glomerular filtration rate or proteinuria. Diabetic nephropathy and hypertensive renal damage are responsible for the majority of cases. The initiation of therapy has to consider if causal treatment of the underlying disease is possible and indicated. In all patients, even if specific treatment is not possible, therapy should aim at reducing progression of kidney failure. Chronic kidney diseases tend to intrinsic deterioration that persists after cessation of the causative damaging pathomechanism...
February 13, 2017: Der Internist
https://www.readbyqxmd.com/read/28157679/myelofibrosis-secondary-to-renal-osteodystrophy
#13
Yasmeen M Butt, Weina Chen
No abstract text is available yet for this article.
October 20, 2016: Blood
https://www.readbyqxmd.com/read/28005175/research-on-kidney-and-mineral-metabolism-in-japan-past-present-and-future
#14
REVIEW
Masahide Mizobuchi, Hiroaki Ogata, Fumihiko Koiwa, Eriko Kinugasa, Tadao Akizawa
Since the identification of the kidney was the main site for the synthesis of calcitriol (1α, 25-dihydroxycholecalciferol), research on chronic kidney disease (CKD)-associated mineral metabolism disorders and their management has made rapid progress. Various active analogues of calcitriol have clinically become available for treating secondary hyperparathyroidism (SHPT), which is a representative mineral metabolism abnormality in CKD patients. A calcimimetic compound cinacalcet hydrochloride has also been developed for the medical management of SHPT through a different mechanism involving the calcium-sensing receptor...
December 22, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27995443/pseudohypoparathyroidism-one-gene-several-syndromes
#15
REVIEW
O Tafaj, H Jüppner
Pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP) are caused by mutations and/or epigenetic changes at the complex GNAS locus on chromosome 20q13.3 that undergoes parent-specific methylation changes at several sites. GNAS encodes the alpha-subunit of the stimulatory G protein (Gsα) and several splice variants thereof. Heterozygous inactivating mutations involving the maternal GNAS exons 1-13 cause PHP type Ia (PHP1A). Because of much reduced paternal Gsα expression in certain tissues, such as the proximal renal tubules, thyroid, and pituitary, there is little or no Gsα protein in the presence of maternal GNAS mutations, thus leading to PTH-resistant hypocalcemia and hyperphosphatemia...
April 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27990791/the-role-of-carbon-adsorbent-in-the-conservative-management-of-chronic-kidney-disease
#16
Toshimitsu Niwa
Indoxyl sulfate is a uremic toxin, and cannot be removed efficiently by hemodialysis due to its protein-binding. Indoxyl sulfate induces cellular dysfunction by producing reactive oxygen species (ROS) such as superoxide by activating nicotinamide adenine dinucleotide phosphate oxidase, and by activating aryl hydrocarbon receptor through its uptake via organic anion transporters (OAT1 and OAT3). Indoxyl sulfate shows toxic effects on a variety of cells such as renal proximal tubular cells, glomerular mesangial cells, vascular smooth muscle cells, vascular endothelial cells, cardiomyocytes, cardiac fibroblasts, monocytes, osteoblasts, osteoclasts, and myocytes...
June 2017: Panminerva Medica
https://www.readbyqxmd.com/read/27896453/management-of-phosphorus-load-in-ckd-patients
#17
REVIEW
Yutaka Taketani, Fumihiko Koiwa, Keitaro Yokoyama
Disturbances in mineral and bone metabolism play a critical role in the pathogenesis of cardiovascular complications in patients with chronic kidney disease (CKD). The term "renal osteodystrophy" has recently been replaced with "CKD-mineral and bone disorder (CKD-MBD)", which includes vascular calcification as well as bone abnormalities. In Japan, proportions of the aged and long-term dialysis patients are increasing which makes management of vascular calcification and parathyroid function increasingly more important...
March 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27800197/a-swelling-in-the-mouth-in-a-chronic-hemodialysis-patient
#18
Arnaud Devresse, Alexandros Raptis, Anne-Sophie Claes, Laura Labriola
Oral manifestations of severe secondary hyperparathyroidism include maxillary and mandibular deformities, brown tumors, dental abnormalities, and metastatic calcification of soft tissues. We report on a chronic hemodialysis (HD) woman with severe, uncontrolled secondary hyperparathyroidism and a painful, nontender mass in the floor of her mouth. The most likely clinical diagnosis was a bone tumoral lesion of the oral cavity, secondary to renal osteodystrophy. Unexpectedly, pathological examination showed characteristic features of ossifying fibroma (OF) of the jaw, a rare, benign fibroosseous lesion characterized by the replacement of normal bone by collagen and fibroblasts containing varying amounts of mineralized substance...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27771603/atraumatic-diplaced-bilateral-femoral-neck-fracture-in-a-patient-with-hypophosphatemic-rickets-in-postpartum-period-a-missed-diagnosis
#19
Erdal Uzun, Ali Eray Günay, Turan Bilge Kızkapan, Mahmut Mutlu
INTRODUCTION: Simultaneous bilateral femoral neck fracture is an uncommon condition. There are very few cases reported in the literature and most of these cases have underlying bone pathologies such as renal osteodystrophy and osteomalacia. In some cases bilateral femoral neck fractures occur due to generalized seizures or high-energy trauma. PRESENTATION OF CASE: In this case report "atraumatic bilateral femoral neck fracture in a 26year old woman in postpartum period with hypophosphatemic rickets disease" is presented...
October 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27728490/study-of-renal-osteodystrophy-in-chronic-kidney-disease
#20
Patel Ar, Mane Rr
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
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