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Chronic kidney disease-mineral and bone disease

Kelsey Connelly, David Collister, Navdeep Tangri
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is associated with the development of mineral bone disorder (MBD), osteoporosis, and fragility fractures. The purpose of this review is to provide an update on recent findings in the diagnosis and treatment of osteoporosis in patients with CKD. RECENT FINDINGS: Multiple observational studies have shown that bone mineral density measurement using DEXA is equally predictive in CKD stages 1-3, as in the general population...
March 15, 2018: Current Opinion in Nephrology and Hypertension
Hai-Tao Hou, Ya-Nan Wang, Shi-Ze Shao, Song Fu, Xiang-Peng Huang, Xiao-Hui Wang
Dietary calcium (Ca) supplementation has beneficial effects on bone health. However, it is not clear whether a high calcium diet (HCD) following 5/6 nephrectomy (5/6 Nx) is beneficial to bone health. The aim of the present study was to examine the effects of an HCD on bone metabolism using a chronic kidney disease (CKD) mouse model. Male C57BL/6J mice were divided into three groups: Sham group, 5/6 Nx group and 5/6 Nx + HCD group. Mice were sacrificed 12 weeks post-surgery. Calcium (Ca) and creatinine (Cr) were measured using standard colorimetric methods and picric acid methods, respectively...
April 2018: Experimental and Therapeutic Medicine
Li-Hua Ni, Ri-Ning Tang, Lin-Li Lv, Min Wu, Bin Wang, Feng Mei Wang, Hai-Feng Ni, Kai-Yun Song, Li-Ting Wang, Meng-Zuo, Qiang Chen, Bi-Cheng Liu
The study of parathyroid hyperplasia with bone disease as a critical manifestation of chronic kidney disease-mineral and bone disorders (CKD-MBDs) is challenging due to the lack of a suitable research model. Here, we established a rat model with secondary hyperparathyroidism (SHPT) and bone disease induced by adenine and a high phosphorous diet and analyzed the skeletal characteristics. We performed blood analysis, emission computed tomography (ECT), dual energy X-ray absorptiometry (DEXA), micro-computed tomography (micro-CT), bone histomorphometry, and bone mechanical tests...
March 12, 2018: Biochemical and Biophysical Research Communications
Pablo Antonio Ureña-Torres, Mario Cozzolino, Jordi Bover
Secondary hyperparathyroidism (SHPT) is one of the most frequent and deleterious complication of chronic kidney disease (CKD). SHPT is also one of the principal components of the now called CKD-mineral and bone disorders (MBD) syndrome. It is usually prevented and treated by vitamin D derivatives. However, the rationale for the prescription of vitamin D sterols in those patients is still a matter of hotly debates, mainly because of unsatisfactory results from numerous observational and not well-controlled studies...
March 12, 2018: Néphrologie & Thérapeutique
Paul Glendenning, S A Paul Chubb, Samuel Vasikaran
Bone turnover marker (BTM's) concentrations in blood and urine reflect bone-remodelling activity, and may be useful adjuncts in the diagnosis and management of metabolic bone diseases. Newer biomarkers, mainly bone regulatory proteins, are currently being investigated to elucidate their role in bone metabolism and disease and may in future be useful in clinical diagnosis and management of metabolic bone disease. BTM concentrations increase around menopause in women, and at a population level the degree of increase in BTM's reflect bone loss...
March 12, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Beata Znorko, Dariusz Pawlak, Ewa Oksztulska-Kolanek, Tomasz Domaniewski, Anna Pryczynicz, Alicja Roszczenko, Joanna Rogalska, Paweł Lipowicz, Michał Doroszko, Malgorzata Michalina Brzoska, Krystyna Pawlak
Osteoprotegerin (OPG), receptor activator of NF-κB ligand (RANKL), and parathyroid hormone (PTH) play a central role in the regulation of bone turnover in chronic kidney disease (CKD), but their influence on bone mineral density (BMD) and strength remains unclear, particularly in children. We studied the clinical significance of OPG and RANKL in relation to PTH, femur weight, BMD, and bone biomechanical properties in growing rats after one month (CKD-1) and three months (CKD-3) of surgically-induced mild CKD...
March 9, 2018: Cytokine
Antonio Bellasi, Luigi Morrone, Maria Cristina Mereu, Carlo Massimetti, Elena Pelizzaro, Giuseppe Cianciolo, Marzia Pasquali, Vincenzo Panuccio
We herein report on a nationwide survey conducted in Italy to investigate the use of parathyroidectomy (PTX). In spite of the availability of newer and more effective drugs to control chronic kidney disease mineral bone disorder (CKD-MBD) biochemical abnormalities, PTX still remains a resource for nephrologists to use. However, observational analyses suggest that in recent years there has been a constant decline in the number of patients undergoing PTX. The reasons are not clear, though the increasing age and number of comorbidities of dialysis patients may partly explain this trend...
March 7, 2018: Journal of Nephrology
Primploy Greeviroj, Thidarat Kitrungphaiboon, Pisut Katavetin, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Bertrand L Jaber, Paweena Susantitaphong
BACKGROUND: Cinacalcet could decrease serum calcium, phosphate, and parathyroid hormone (PTH) in previous meta-analyses. However, the effect of cinacalcet on the new biomarkers such as fibroblast growth factor-23 (FGF-23), bone markers, and vascular calcification are still unestablished. We conducted a meta-analysis to examine the effects of cinacalcet on all laboratory and clinical spectrums of chronic kidney disease-mineral bone disorders (CKD-MBD). METHODS: A systematic literature search was conducted in MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and Clinical Trials...
March 7, 2018: Nephron
Kristen L Nowak, Michel Chonchol
Chronic, low-grade inflammation is a common comorbid condition in chronic kidney disease (CKD), and particularly in chronic dialysis patients. In this review, we consider the question of whether inflammation affects outcomes in dialysis patients. Levels of proinflammatory cytokines, as well as C-reactive protein, are elevated in chronic dialysis patients. Multiple factors likely contribute to chronic inflammatory activation in kidney disease patients including the uremic milieu, lifestyle and epigenetic influences, infectious and thrombotic events, the dialysis process, and dysbiosis...
March 7, 2018: Seminars in Dialysis
Hyo Jin Kim, Eunjeong Kang, Yun Kyu Oh, Yeong Hoon Kim, Seung Hyeok Han, Tae Hyun Yoo, Dong-Wan Chae, Joongyub Lee, Curie Ahn, Kook-Hwan Oh
BACKGROUND: Klotho, a protein linked to aging, has emerged as a pivotal player in mineral bone metabolism and might explain the relationship between chronic kidney disease (CKD) and cardiovascular disease (CVD). The present study aimed to investigate the association between serum klotho and cardiac parameters from a large-scale Korean CKD cohort. METHODS: We analyzed 2101 participants from KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) cohort who had been measured for serum klotho levels...
March 5, 2018: BMC Nephrology
N Segaud, I Legroux, M Hazzan, C Noel, B Cortet
INTRODUCTION: In renal transplant patients, bone loss may be related to the drugs patients are taking but also to their past history of chronic kidney disease. The purpose of this study was to assess changes in BMD 2 years after an initial assessment (performed 9 months post transplantation) and the factors associated with these changes. METHODS: This longitudinal study included patients who had undergone a renal transplantation between 2005 and 2011, and who were followed up at the Lille Regional University Hospital...
March 2, 2018: Osteoporosis International
A Yajima, K Tsuchiya, L F Bonewald, M Inaba, Y Tominaga, T Tanizawa, A Ito, K Nitta
Evaluation of bone is of great importance in chronic kidney disease patients, as these patients are at an increased risk for fractures. We treated a hemodialysis patient suffering from hyperparathyroid bone disease with cinacalcet hydrochloride and concurrent administration of maxacalcitol and alfacalcidol for a year. Hyperparathyroid bone disease is characterized by cortical thinning, increased cortical porosity, reduced trabecular bone volume, and increased hypomineralized matrix volume, and there is little information to date about the effects of treatment with cinacalcet hydrochloride on the bone fragility in patients with hyperparathyroid bone disease...
February 28, 2018: Osteoporosis International
Christian Lerch, Rukshana Shroff, Mandy Wan, Lesley Rees, Helen Aitkenhead, Ipek Kaplan Bulut, Daniela Thurn, Aysun Karabay Bayazit, Anna Niemirska, Nur Canpolat, Ali Duzova, Karolis Azukaitis, Ebru Yilmaz, Fatos Yalcinkaya, Jerome Harambat, Aysel Kiyak, Harika Alpay, Sandra Habbig, Ariane Zaloszyc, Oguz Soylemezoglu, Cengiz Candan, Alejandra Rosales, Anette Melk, Uwe Querfeld, Maren Leifheit-Nestler, Anja Sander, Franz Schaefer, Dieter Haffner
Background: We investigated the effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism, i.e. serum levels of fibroblast growth factor 23 (FGF23), Klotho, bone alkaline phosphatase (BAP) and sclerostin, in two cohorts with chronic kidney disease (CKD). Methods: In all, 80 vitamin D-deficient children were selected: 40 with mild to moderate CKD from the ERGO study, a randomized trial of ergocalciferol supplementation [estimated glomerular filtration rate (eGFR) 55 mL/min/1...
February 21, 2018: Nephrology, Dialysis, Transplantation
Marta Christov, Abbe R Clark, Braden Corbin, Samy Hakroush, Eugene P Rhee, Hiroaki Saito, Dan Brooks, Eric Hesse, Mary Bouxsein, Niels Galjart, Ji Yong Jung, Peter Mundel, Harald Jüppner, Astrid Weins, Anna Greka
Progressive chronic kidney diseases (CKDs) are on the rise worldwide. However, the sequence of events resulting in CKD progression remain poorly understood. Animal models of CKD exploring these issues are confounded by systemic toxicities or surgical interventions to acutely induce kidney injury. Here we report the generation of a CKD mouse model through the inducible podocyte-specific ablation of an essential endogenous molecule, the chromatin structure regulator CCCTC-binding factor (CTCF), which leads to rapid podocyte loss (iCTCFpod-/-)...
February 22, 2018: JCI Insight
Markus Ketteler, Geoffrey A Block, Pieter Evenepoel, Masafumi Fukagawa, Charles A Herzog, Linda McCann, Sharon M Moe, Rukshana Shroff, Marcello A Tonelli, Nigel D Toussaint, Marc G Vervloet, Mary B Leonard
Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update and the original publication are intended to assist practitioners caring for adults with CKD and those receiving long-term dialysis. Methods: Development of the guideline update followed an explicit process of evidence review and appraisal...
February 20, 2018: Annals of Internal Medicine
Tatjana Kanjevac, Borivoj Bijelic, Denis Brajkovic, Miroslav Vasovic, Radojica Stolic
Chronic kidney disease (CKD) has become a worldwide public health problem. It is estimated that nearly 90% of patients with chronic renal failure manifest some symptoms of oral disease. With advances in medical treatment, CKD patients are living longer and require oral care. Chronic kidney disease is often accompanied by disturbances in mineral metabolism which are classified as their own clinical entity known as CKD-mineral and bone disorder (CKD-MBD). CKD-MBD affects all aspects of bone physiology: bone volume, bone turnover and bone mineralization...
2018: Oral Health & Preventive Dentistry
Chien-Ning Hsu, Hsiang-Wen Lin, A Simon Pickard, You-Lin Tain
Objective: To assess if health-related quality of life (HRQOL) of children with chronic kidney disease (CKD) and different comorbid conditions can be identified based on the EQ-5D child-friendly version (EQ-5D-Y). Design: Prospective cross-sectional study. Setting: A tertiary care medical center in Taiwan. Study participants: All CKD patients aged 7-18 years treated at the center between May 2014 and December 2016. Main Outcome Measures: HRQOL assessment was done using EQ-5D-Y...
February 13, 2018: International Journal for Quality in Health Care
Jordi Bover, Pablo Ureña, Armando Aguilar, Sandro Mazzaferro, Silvia Benito, Víctor López-Báez, Alejandra Ramos, Iara daSilva, Mario Cozzolino
Alkaline phosphatases (APs) remove the phosphate (dephosphorylation) needed in multiple metabolic processes (from many molecules such as proteins, nucleotides, or pyrophosphate). Therefore, APs are important for bone mineralization but paradoxically they can also be deleterious for other processes, such as vascular calcification and the increasingly known cross-talk between bone and vessels. A proper balance between beneficial and harmful activities is further complicated in the context of chronic kidney disease (CKD)...
February 14, 2018: Calcified Tissue International
Katarzyna Muras-Szwedziak, Michal Nowicki
BACKGROUND/AIMS: Both iron deficiency and chronic inflammation are highly prevalent in patients with chronic kidney disease (CKD). The effect of intravenous iron infusion on mineral metabolism in CKD may be modified by inflammation. Intravenous iron theraphy may reduce peripheral degradation, secretion, clearence of iFGF23 and lead to hypophosphatemia. The aim of the study was to evaluate the effect of intravenous iron on mineral metabolism in CKD patients. METHODS: 35 non-dialysis patients with CKD stages 3-5...
February 8, 2018: Kidney & Blood Pressure Research
Jun Li, Guangqun Xing, Lili Zhang, Jinchun Shang, Yuan Li, Chunmei Li, Fen Tian, Xiangdong Yang
Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a complex disease which is associated with alterations of bone and mineral metabolism. miR-223 is implicated in both vascular calcification and osteoporosis. In the present study, we investigated the influence of Stab1 gene on miRNA-223 expression in osteoclastogenesis. Differentiation of monocyte/macrophage precursors was assessed by using RAW264.7 cells and peripheral blood mononuclear cells (PBMC). TRAP activity and bone resorption were used to measure osteoclast activity...
November 1, 2017: Die Pharmazie
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