The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review
Although frequently silent, mineral and bone disease (MBD) is one of the most precocious complication of chronic kidney disease (CKD) and is omnipresent in patients with CKD stage 5. Its pathophysiology is complex, but basically, disturbances in vitamin D, phosphate, and calcium metabolism lead to a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/5/772 |
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| author | Ana Pimentel Jordi Bover Grahame Elder Martine Cohen-Solal Pablo Antonio Ureña-Torres |
| author_facet | Ana Pimentel Jordi Bover Grahame Elder Martine Cohen-Solal Pablo Antonio Ureña-Torres |
| author_sort | Ana Pimentel |
| collection | DOAJ |
| description | Although frequently silent, mineral and bone disease (MBD) is one of the most precocious complication of chronic kidney disease (CKD) and is omnipresent in patients with CKD stage 5. Its pathophysiology is complex, but basically, disturbances in vitamin D, phosphate, and calcium metabolism lead to a diverse range of clinical manifestations with secondary hyperparathyroidism usually being the most frequent. With the decline in renal function, CKD-MBD may induce microstructural changes in bone, vascular system and soft tissues, which results in macrostructural lesions, such as low bone mineral density (BMD) resulting in skeletal fractures, vascular and soft tissue calcifications. Moreover, low BMD, fractures, and vascular calcifications are linked with increased risk of cardiovascular mortality and all-cause mortality. Therefore, a better characterization of CKD-MBD patterns, beyond biochemical markers, is helpful to adapt therapies and monitor strategies as used in the general population. An in-depth characterization of bone health is required, which includes an evaluation of cortical and trabecular bone structure and density and the degree of bone remodeling through bone biomarkers. Standard radiological imaging is generally used for the diagnosis of fracture or pseudo-fractures, vascular calcifications and other features of CKD-MBD. However, bone fractures can also be diagnosed using computed tomography (CT) scan, magnetic resonance (MR) imaging and vertebral fracture assessment (VFA). Fracture risk can be predicted by bone densitometry using dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QTC) and peripheral quantitative computed tomography (pQTC), quantitative ultrasound (QUS) and most recently magnetic resonance micro-imaging. Quantitative methods to assess bone consistency and strength complete the study and adjust the clinical management when integrated with clinical factors. The aim of this review is to provide a brief and comprehensive update of imaging techniques available for the diagnosis, prevention, treatment and monitoring of CKD-MBD. |
| first_indexed | 2024-03-10T11:57:49Z |
| format | Article |
| id | doaj.art-49ed15e2cc4a47c68ff83bad271ae142 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T11:57:49Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-49ed15e2cc4a47c68ff83bad271ae1422023-11-21T17:09:01ZengMDPI AGDiagnostics2075-44182021-04-0111577210.3390/diagnostics11050772The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic ReviewAna Pimentel0Jordi Bover1Grahame Elder2Martine Cohen-Solal3Pablo Antonio Ureña-Torres4Department of Dialysis AURA Nord Saint Ouen, 93400 Saint Ouen, FranceFundació Puigvert, Department of Nephrology, IIB Sant Pau, RedinRen, Barcelona, 08025 Catalonia, SpainDepartment of Renal Medicine, Westmead Hospital, Sydney, NSW 2145, AustraliaBioscar INSERM U1132, Department of Rheumatology, Université de Paris, Hôpital Lariboisière, 75010 Paris, FranceDepartment of Dialysis AURA Nord Saint Ouen, 93400 Saint Ouen, FranceAlthough frequently silent, mineral and bone disease (MBD) is one of the most precocious complication of chronic kidney disease (CKD) and is omnipresent in patients with CKD stage 5. Its pathophysiology is complex, but basically, disturbances in vitamin D, phosphate, and calcium metabolism lead to a diverse range of clinical manifestations with secondary hyperparathyroidism usually being the most frequent. With the decline in renal function, CKD-MBD may induce microstructural changes in bone, vascular system and soft tissues, which results in macrostructural lesions, such as low bone mineral density (BMD) resulting in skeletal fractures, vascular and soft tissue calcifications. Moreover, low BMD, fractures, and vascular calcifications are linked with increased risk of cardiovascular mortality and all-cause mortality. Therefore, a better characterization of CKD-MBD patterns, beyond biochemical markers, is helpful to adapt therapies and monitor strategies as used in the general population. An in-depth characterization of bone health is required, which includes an evaluation of cortical and trabecular bone structure and density and the degree of bone remodeling through bone biomarkers. Standard radiological imaging is generally used for the diagnosis of fracture or pseudo-fractures, vascular calcifications and other features of CKD-MBD. However, bone fractures can also be diagnosed using computed tomography (CT) scan, magnetic resonance (MR) imaging and vertebral fracture assessment (VFA). Fracture risk can be predicted by bone densitometry using dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QTC) and peripheral quantitative computed tomography (pQTC), quantitative ultrasound (QUS) and most recently magnetic resonance micro-imaging. Quantitative methods to assess bone consistency and strength complete the study and adjust the clinical management when integrated with clinical factors. The aim of this review is to provide a brief and comprehensive update of imaging techniques available for the diagnosis, prevention, treatment and monitoring of CKD-MBD.https://www.mdpi.com/2075-4418/11/5/772bonefracturebone mineral densitycomputed tomographycortical bonetrabecular bone |
| spellingShingle | Ana Pimentel Jordi Bover Grahame Elder Martine Cohen-Solal Pablo Antonio Ureña-Torres The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review Diagnostics bone fracture bone mineral density computed tomography cortical bone trabecular bone |
| title | The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review |
| title_full | The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review |
| title_fullStr | The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review |
| title_full_unstemmed | The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review |
| title_short | The Use of Imaging Techniques in Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD)—A Systematic Review |
| title_sort | use of imaging techniques in chronic kidney disease mineral and bone disorders ckd mbd a systematic review |
| topic | bone fracture bone mineral density computed tomography cortical bone trabecular bone |
| url | https://www.mdpi.com/2075-4418/11/5/772 |
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