Bone fragility in patients with chronic kidney disease
Mineral and bone diseases (MBD) are predominant in patients with chronic kidney disease (CKD) and lead to several bone manifestations, from pain to skeletal fractures. Cumulative traditional clinical risk factors, such as age and gender, in addition to those related to CKD, enhance the risk of comor...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2020-04-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/9/4/EC-20-0039.xml |
| _version_ | 1817988520713650176 |
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| author | Martine Cohen-Solal Thomas Funck-Brentano Pablo Ureña Torres |
| author_facet | Martine Cohen-Solal Thomas Funck-Brentano Pablo Ureña Torres |
| author_sort | Martine Cohen-Solal |
| collection | DOAJ |
| description | Mineral and bone diseases (MBD) are predominant in patients with chronic kidney disease (CKD) and lead to several bone manifestations, from pain to skeletal fractures. Cumulative traditional clinical risk factors, such as age and gender, in addition to those related to CKD, enhance the risk of comorbidity and mortality related to fractures. Despite great advances in understanding MBD in CKD, clinical and biological targets are lacking, which leads to under-management of fractures. Optimal PTH control results in a net improvement in defining the levels of bone remodeling. In addition, circulating biomarkers such as bone-specific alkaline phosphatase and cross-linked collagen type I peptide will also provide additional information about remodeling rate, bone mineralization and the evaluation of fracture risk. Imaging techniques identify patients at risk by measurement of bone mineral density by DEXA or by high peripheral QCT, which allow the discrimination of trabecular and cortical bone. Here, we have reviewed the literature related to epidemiology and the pathophysiological role of mineral and biochemical factors involved in CKD-MBD with a special focus on fracture risk. We also provide an algorithm that could be used for the management of bone diseases and to guide treatment decisions. Finally, the combined expertise of clinicians from various disciplines is crucial for the best prevention of fractures. |
| first_indexed | 2024-04-14T00:35:11Z |
| format | Article |
| id | doaj.art-a4664d82855a4d38a0becc4c2490ac47 |
| institution | Directory Open Access Journal |
| issn | 2049-3614 2049-3614 |
| language | English |
| last_indexed | 2024-04-14T00:35:11Z |
| publishDate | 2020-04-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-a4664d82855a4d38a0becc4c2490ac472022-12-22T02:22:24ZengBioscientificaEndocrine Connections2049-36142049-36142020-04-0194R93R101https://doi.org/10.1530/EC-20-0039Bone fragility in patients with chronic kidney diseaseMartine Cohen-Solal0Thomas Funck-Brentano1Pablo Ureña Torres2Department of Skeletal Diseases, INSERM U1132 & Université de Paris, Hôpital Lariboisière, Paris, FranceDepartment of Skeletal Diseases, INSERM U1132 & Université de Paris, Hôpital Lariboisière, Paris, FranceAURA Nord, Saint Ouen, France; Department of Renal Physiology, Necker Hospital, Université de Paris, Paris, FranceMineral and bone diseases (MBD) are predominant in patients with chronic kidney disease (CKD) and lead to several bone manifestations, from pain to skeletal fractures. Cumulative traditional clinical risk factors, such as age and gender, in addition to those related to CKD, enhance the risk of comorbidity and mortality related to fractures. Despite great advances in understanding MBD in CKD, clinical and biological targets are lacking, which leads to under-management of fractures. Optimal PTH control results in a net improvement in defining the levels of bone remodeling. In addition, circulating biomarkers such as bone-specific alkaline phosphatase and cross-linked collagen type I peptide will also provide additional information about remodeling rate, bone mineralization and the evaluation of fracture risk. Imaging techniques identify patients at risk by measurement of bone mineral density by DEXA or by high peripheral QCT, which allow the discrimination of trabecular and cortical bone. Here, we have reviewed the literature related to epidemiology and the pathophysiological role of mineral and biochemical factors involved in CKD-MBD with a special focus on fracture risk. We also provide an algorithm that could be used for the management of bone diseases and to guide treatment decisions. Finally, the combined expertise of clinicians from various disciplines is crucial for the best prevention of fractures.https://ec.bioscientifica.com/view/journals/ec/9/4/EC-20-0039.xmlboneskeletonfracturebone mineral densityckd-mbdphosphatecalciumparathyroid hormonevitamin d |
| spellingShingle | Martine Cohen-Solal Thomas Funck-Brentano Pablo Ureña Torres Bone fragility in patients with chronic kidney disease Endocrine Connections bone skeleton fracture bone mineral density ckd-mbd phosphate calcium parathyroid hormone vitamin d |
| title | Bone fragility in patients with chronic kidney disease |
| title_full | Bone fragility in patients with chronic kidney disease |
| title_fullStr | Bone fragility in patients with chronic kidney disease |
| title_full_unstemmed | Bone fragility in patients with chronic kidney disease |
| title_short | Bone fragility in patients with chronic kidney disease |
| title_sort | bone fragility in patients with chronic kidney disease |
| topic | bone skeleton fracture bone mineral density ckd-mbd phosphate calcium parathyroid hormone vitamin d |
| url | https://ec.bioscientifica.com/view/journals/ec/9/4/EC-20-0039.xml |
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