scholarly journals Calciphylaxis associated with chronic kidney disease and low bone turnover: management with recombinant human PTH-(1-34)

2008 ◽  
Vol 1 (2) ◽  
pp. 97-99 ◽  
Author(s):  
G. Elder ◽  
K. S. Kumar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Turnover ◽  
Low Bone Turnover

scholarly journals Biomarkers of Bone Turnover Identify Subsets of Chronic Kidney Disease Patients at Higher Risk for Fracture

2020 ◽  
Vol 105 (8) ◽  
pp. e2903-e2911 ◽  
Author(s):  
Jan M Hughes-Austin ◽  
Ronit Katz ◽  
Richard D Semba ◽  
Stephen B Kritchevsky ◽  
Douglas C Bauer ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Bone Histomorphometry ◽  
Bone Biopsy ◽  
Hazard Ratio ◽  
Community Dwelling ◽  
Low Bone Turnover ◽  
Fgf 23

Abstract Background We sought to identify biomarkers that indicate low turnover on bone histomorphometry in chronic kidney disease (CKD) patients, and subsequently determined whether this panel identified differential risk for fractures in community-dwelling older adults. Methods Among CKD patients who underwent iliac crest bone biopsies and histomorphometry, we evaluated candidate biomarkers to differentiate low turnover from other bone disease. We applied this biomarker panel to 641 participants in the Health Aging and Body Composition Study (Health ABC) study with estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 who were followed for fracture. Cox proportional hazards models evaluated the association of bone mineral density (BMD) with fracture risk and determined whether biomarker-defined low bone turnover modified fracture risk at any level of BMD. Results In 39 CKD patients age 64 ± 13 years, 85% female, with mean eGFR 37 ± 14 mL/min/1.73 m2 who underwent bone biopsy, lower fibroblast growth factor (FGF)-23, higher ɑ-Klotho, and lower parathyroid hormone (PTH) indicated low bone turnover in accordance with bone histomorphometry parameters (individual area under the curve = 0.62, 0.73, and 0.55 respectively; sensitivity = 22%, specificity = 100%). In Health ABC, 641 participants with CKD were age 75 ± 3 years , 49% female, with mean eGFR 48 ± 10 mL/min/1.73 m2. For every SD lower hip BMD at baseline, there was an 8-fold higher fracture risk in individuals with biomarker-defined low turnover (hazard ratio 8.10 [95% CI, 3.40-19.30]) vs a 2-fold higher risk in the remaining individuals (hazard ratio 2.28 [95% CI, 1.69-3.08]) (Pinteraction = .082). Conclusions In CKD patients who underwent bone biopsy, lower FGF-23, higher ɑ-Klotho, and lower PTH together had high specificity for identifying low bone turnover. When applied to older individuals with CKD, BMD was more strongly associated with fracture risk in those with biomarker-defined low turnover.

scholarly journals The Novel Bone Alkaline Phosphatase Isoform B1x Is Associated with Improved 5-Year Survival in Chronic Kidney Disease

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4402
Author(s):  
Mathias Haarhaus ◽  
Anders Fernström ◽  
Abdul Rashid Qureshi ◽  
Per Magnusson
Keyword(s):  
Chronic Kidney Disease ◽  
Alkaline Phosphatase ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Bone Turnover ◽  
Aortic Pulse Wave Velocity ◽  
Bone Alkaline Phosphatase ◽  
Protein Energy Wasting ◽  
Wasting Syndrome ◽  
Low Bone Turnover

Circulating alkaline phosphatase (ALP) is an independent cardiovascular risk marker. Serum bone ALP (BALP) isoforms indicate bone turnover and comprise approximately 50% of total circulating ALP. In chronic kidney disease (CKD), mortality is highest in patients with increased ALP and BALP and low bone turnover. However, not all low bone turnover states are associated with increased mortality. Chronic inflammation and oxidative stress, features of protein energy wasting syndrome, induce cardiovascular BALP activity and fibro-calcification, while bone turnover is suppressed. Circulating BALP isoform B1x is associated with low ALP and low bone turnover and has been exclusively detected in CKD. We investigated the association of serum B1x with survival, abdominal aortic calcification (AAC) score, and aortic pulse wave velocity (PWV) in CKD. Serum ALP, BALP isoforms, parathyroid hormone (PTH), PWV, and AAC were measured repeatedly over 2 years in 68 prevalent dialysis patients. Mortality was assessed after 5 years. B1x was detected in 53 patients. A competing risk analysis revealed an association of B1x with improved 5-year survival; whereas, baseline PWV, but not AAC score, predicted mortality. However, PWV improved in 26 patients (53%), and B1x was associated with variation of PWV over time (p = 0.03). Patients with B1x had lower PTH and total ALP, suggesting an association with lower bone turnover. In conclusion, B1x is associated with time-varying PWV, lower circulating ALP, and improved survival in CKD, and thus may be an indicator of a reduced cardiovascular risk profile among patients with low bone turnover.

Assessment of bone turnover markers to predict mineral and bone disorder in men with pre-dialysis non-diabetic chronic kidney disease

2017 ◽  
Vol 469 ◽  
pp. 195-200 ◽  
Author(s):  
Joseph Jessy Davina ◽  
M. Priyadarssini ◽  
Medha Rajappa ◽  
Sreejith Parameswaran ◽  
Jayaprakash Sahoo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Turnover ◽  
Bone Turnover Markers ◽  
Mineral And Bone Disorder ◽  
Bone Disorder ◽  
Turnover Markers

Corrigendum to “Association of bone turnover markers and arterial stiffness in pre-dialysis chronic kidney disease (CKD)” [Bone 48 (2011) 1127–1132]

Bone ◽  
2011 ◽  
Vol 49 (3) ◽  
pp. 588
Author(s):  
P. Manghat ◽  
I. Souleimanova ◽  
J. Cheung ◽  
A.S. Wierzbicki ◽  
D.J. Harrington ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Stiffness ◽  
Bone Turnover ◽  
Bone Turnover Markers ◽  
Turnover Markers

scholarly journals Adenine-induced chronic kidney disease induces a similar skeletal phenotype in male and female C57BL/6 mice with more severe deficits in cortical bone properties of male mice

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250438
Author(s):  
Corinne E. Metzger ◽  
Elizabeth A. Swallow ◽  
Alexander J. Stacy ◽  
Matthew R. Allen
Keyword(s):  
Mechanical Properties ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Turnover ◽  
Cortical Bone ◽  
Male Mice ◽  
Male And Female ◽  
High Bone Turnover ◽  
Female Mice ◽  
High Bone

Chronic kidney disease (CKD) causes bone loss, particularly in cortical bone, through formation of cortical pores which lead to skeletal fragility. Animal models of CKD have shown variability in the skeletal response to CKD between males and females suggesting sex may play a role in this variation. Our aim was to compare the impact of adenine-induced CKD on cortical parameters in skeletally mature male and female C57Bl/6 mice. After 10-weeks of adenine-induced CKD, both male and female adenine mice had high serum parathyroid hormone (PTH), high bone turnover, and cortical porosity compared to non-CKD controls. Both sexes had lower cortical thickness, but only male mice had lower cortical bone area. CKD imparted greater deficits in mechanical properties of male mice compared to female mice. These data demonstrate that both male and female mice develop high PTH/high bone turnover in response to adenine-induced CKD and that cortical bone phenotypes are slightly more severe in males, particularly in mechanical properties deficits.

Inhibitors of canonical Wnt signaling pathway and inorganic phosphate imbalance in experimental chronic kidney disease

2019 ◽  
Vol 23 (6) ◽  
pp. 83-91 ◽  
Author(s):  
E. O. Bogdanova ◽  
O. N. Beresneva ◽  
I. M. Zubina ◽  
G. T. Ivanova ◽  
M. M. Parastaeva ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Turnover ◽  
Wnt Signaling ◽  
Inorganic Phosphate ◽  
Metabolic Disorders ◽  
Wnt Signaling Pathway ◽  
Serum Concentrations ◽  
Canonical Wnt Signaling ◽  
Canonical Wnt

BACKGROUND. The molecular mechanisms of the initial stages of inorganic phosphate (Pi) metabolic disorders in chronic kidney disease (CKD) remain poorly understood.THE AIM. To test the hypothesis about changes in canonical Wnt signaling pathway inhibitors biosynthesis and a concomitant decrease in bone turnover as one of early mechanisms of Pi imbalance in CKD.MATERIAL AND METHODS. Creatinine (Cr), inorganic phosphate (Pi), serum parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), osteoprotegerin (OPG), sclerostin (SOST) and Dickkopf-1 (DKK), renal SOST and DKK mRNA expression, albuminuria (Alb), proteinuria (uTP) levels, fractional (FEPi) and daily (uPi24) Pi excretion were analyzed in SHR rats (N = 52) with 3/4 nephrectomy (NE) or sham operation (SO) and observation periods of 2, 4, and 6 months.RESULTS. Experimental model was comparable with 1-2 stages of CKD. In groups NE4 and NE6, the concentration of sPi and renal Pi excretion (FEPi and uPi24) were significantly higher vs corresponding controls SO4 (p = 0.006, p <0.010) and SO6 (p = 0.002, p = 0.028). Serum concentrations of FGF23 and PTH in NE and SO animals did not change significantly. In NE4 and NE6 groups, serum SOST and DKK concentrations were significantly higher vs controls (p <0.049, p <0.043), while the kidney expression SOST and DKK mRNA in NE rats did not change significantly or decreased (p = 0.002, p <0.011). The serum concentration of OPG was higher in the NE6 vs SO6 control (p = 0.028).CONCLUSION. The initial stages of experimental CKD are characterized by an increase in serum concentrations of Dikkopf-1, sclerostin and osteoprotegerin. The obtained data suggest the possible role of canonical Wnt signaling inhibition and reduction of bone turnover in the pathogenesis of Pi metabolic disorders in early stages of CKD.

scholarly journals Sevelamer and the bone–vascular axis in chronic kidney disease: bone turnover, inflammation, and calcification regulation

2009 ◽  
Vol 76 ◽  
pp. S26-S33 ◽  
Author(s):  
Vincent M. Brandenburg ◽  
Willi Jahnen-Dechent ◽  
Markus Ketteler
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Turnover

scholarly journals Low Bone Turnover in Chronic Kidney Disease Is Associated with Decreased VEGF-A Expression and Osteoblast Differentiation

2015 ◽  
Vol 41 (6) ◽  
pp. 464-473 ◽  
Author(s):  
Neal X. Chen ◽  
Kalisha D. O''Neill ◽  
Matthew R. Allen ◽  
Christopher L. Newman ◽  
Sharon M. Moe
Keyword(s):  
Chronic Kidney Disease ◽  
Transcription Factors ◽  
Kidney Disease ◽  
Osteoblast Differentiation ◽  
Alternative Hypothesis ◽  
Hypoxia Inducible Factor ◽  
Low Bone Turnover ◽  
And Oxidative Stress ◽  
Different Levels ◽  
Pth Level

Background: Low turnover bone (low bone formation rates (BFRs)) with decreased osteoblast number is common in patients with chronic kidney disease (CKD) and attributed to ‘over-suppression' of the parathyroid hormone (PTH) despite supra-physiologic levels. An alternative hypothesis is abnormal osteoblast differentiation, resulting in low BFRs due to reduced VEGF-A. Methods: We analyzed the expression of VEGF-A and mesenchymal stem cell (MSC) differentiation factors in freshly isolated bone marrow (BM) cells, and in BM cell-derived MSC in rats with different levels of BFRs and PTH (modulated by calcium and zoledronic acid). The regulators of VEGF in MSC were also determined. Results: VEGF-A expression was reduced in the BM cells from CKD vs. normal animals (p < 0.02). In BM-derived MSC from CKD, there were decreased osteoblast transcription factors and mineralization. In CKD animals, the BM VEGF-A expression was positively correlated with BFR (r = 0.80, p < 0.001). Reducing BFRs in CKD animals led to reductions in VEGF-A expression and osteoblast transcription factors regardless of the PTH level. We therefore examined other regulators of VEGF-A and found decreased expression of hypoxia-inducible factor-1α and the master transcription factor of antioxidants nuclear factor (erythroid-derived 2)-like 2 in CKD animals with low PTH. Conclusion: Low BFRs in CKD are associated with a basal decrease in VEGF-A expression in BM that may be driven by altered hypoxia and oxidative stress.

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