Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study
<p>Abstract</p> <p>Background</p> <p>Pro-inflammatory cytokines play a key role in bone remodeling. Inflammation is highly prevalent in CKD-5D patients, but the relationship between pro-inflammatory cytokines and fractures in CKD-5D patients is unclear. We studied the r...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-10-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-2369/13/134 |
| _version_ | 1828230936461836288 |
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| author | Panuccio Vincenzo Enia Giuseppe Tripepi Rocco Aliotta Roberta Mallamaci Francesca Tripepi Giovanni Zoccali Carmine |
| author_facet | Panuccio Vincenzo Enia Giuseppe Tripepi Rocco Aliotta Roberta Mallamaci Francesca Tripepi Giovanni Zoccali Carmine |
| author_sort | Panuccio Vincenzo |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Pro-inflammatory cytokines play a key role in bone remodeling. Inflammation is highly prevalent in CKD-5D patients, but the relationship between pro-inflammatory cytokines and fractures in CKD-5D patients is unclear. We studied the relationship between inflammatory cytokines and incident bone fractures in a cohort of CKD-5D patients.</p> <p>Methods</p> <p>In 100 CKD-5D patients (66 on HD, 34 on CAPD; males:63, females:37; mean age: 61 ± 15; median dialysis vintage: 43 months) belonging to a single renal Unit, we measured at enrolment bone metabolic parameters (intact PTH, bone and total alkaline phosphatase, calcium, phosphate) and inflammatory cytokines (TNF-α, IL-6, CRP). Patients were followed-up until the first non traumatic fracture.</p> <p>Results</p> <p>During follow-up (median: 74 months; range 0.5 -84.0) 18 patients experienced fractures. On categorical analysis these patients compared to those without fractures had significantly higher intact PTH (median: 319 pg/ml IQ range: 95–741 vs 135 pg/ml IQ: 53–346; p = 0.04) and TNF-α levels (median: 12 pg/ml IQ: 6.4-13.4 vs 7.8 pg/ml IQ: 4.6-11; p = 0.02). Both TNF-α (HR for 5 pg/ml increase in TNF-α: 1.62 95% CI: 1.05-2.50; p = 0.03) and intact PTH (HR for 100 pg/ml increase in PTH: 1.15 95% CI: 1.04-1.27; p = 0.005) predicted bone fractures on univariate Cox’s regression analysis. In restricted (bivariate) models adjusting for previous fractures, age, sex and other risk factors both PTH and TNF-α maintained an independent association with incident fractures.</p> <p>Conclusions</p> <p>In our bivariate analyses TNF-α was significantly associated with incident fractures. Analyses in larger cohorts and with adequate number of events are needed to firmly establish the TNF α -fracture link emerged in the present study.</p> |
| first_indexed | 2024-04-12T18:55:42Z |
| format | Article |
| id | doaj.art-6ac78975e9d64b7896770a72851026f4 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-12T18:55:42Z |
| publishDate | 2012-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-6ac78975e9d64b7896770a72851026f42022-12-22T03:20:20ZengBMCBMC Nephrology1471-23692012-10-0113113410.1186/1471-2369-13-134Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre studyPanuccio VincenzoEnia GiuseppeTripepi RoccoAliotta RobertaMallamaci FrancescaTripepi GiovanniZoccali Carmine<p>Abstract</p> <p>Background</p> <p>Pro-inflammatory cytokines play a key role in bone remodeling. Inflammation is highly prevalent in CKD-5D patients, but the relationship between pro-inflammatory cytokines and fractures in CKD-5D patients is unclear. We studied the relationship between inflammatory cytokines and incident bone fractures in a cohort of CKD-5D patients.</p> <p>Methods</p> <p>In 100 CKD-5D patients (66 on HD, 34 on CAPD; males:63, females:37; mean age: 61 ± 15; median dialysis vintage: 43 months) belonging to a single renal Unit, we measured at enrolment bone metabolic parameters (intact PTH, bone and total alkaline phosphatase, calcium, phosphate) and inflammatory cytokines (TNF-α, IL-6, CRP). Patients were followed-up until the first non traumatic fracture.</p> <p>Results</p> <p>During follow-up (median: 74 months; range 0.5 -84.0) 18 patients experienced fractures. On categorical analysis these patients compared to those without fractures had significantly higher intact PTH (median: 319 pg/ml IQ range: 95–741 vs 135 pg/ml IQ: 53–346; p = 0.04) and TNF-α levels (median: 12 pg/ml IQ: 6.4-13.4 vs 7.8 pg/ml IQ: 4.6-11; p = 0.02). Both TNF-α (HR for 5 pg/ml increase in TNF-α: 1.62 95% CI: 1.05-2.50; p = 0.03) and intact PTH (HR for 100 pg/ml increase in PTH: 1.15 95% CI: 1.04-1.27; p = 0.005) predicted bone fractures on univariate Cox’s regression analysis. In restricted (bivariate) models adjusting for previous fractures, age, sex and other risk factors both PTH and TNF-α maintained an independent association with incident fractures.</p> <p>Conclusions</p> <p>In our bivariate analyses TNF-α was significantly associated with incident fractures. Analyses in larger cohorts and with adequate number of events are needed to firmly establish the TNF α -fracture link emerged in the present study.</p>http://www.biomedcentral.com/1471-2369/13/134Bone fracturesCKDDialysisHyperparathyroidismTNF-alphaInflammation |
| spellingShingle | Panuccio Vincenzo Enia Giuseppe Tripepi Rocco Aliotta Roberta Mallamaci Francesca Tripepi Giovanni Zoccali Carmine Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study BMC Nephrology Bone fractures CKD Dialysis Hyperparathyroidism TNF-alpha Inflammation |
| title | Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study |
| title_full | Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study |
| title_fullStr | Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study |
| title_full_unstemmed | Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study |
| title_short | Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study |
| title_sort | pro inflammatory cytokines and bone fractures in ckd patients an exploratory single centre study |
| topic | Bone fractures CKD Dialysis Hyperparathyroidism TNF-alpha Inflammation |
| url | http://www.biomedcentral.com/1471-2369/13/134 |
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