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Mineral bone disease of CKD

Ronald B Brown
An association between periodontal disease and cancer has been established in recent studies, but no common etiology has been identified in the hopes of reducing the global burden of these non-communicable diseases. This perspective article hypothesizes that the determinant mediating the association of periodontal disease with cancer is dysregulated phosphate metabolism. Phosphate, an essential dietary micronutrient, is dysregulated in chronic kidney disease, and both cancer and periodontal disease are associated with chronic kidney disease...
February 11, 2019: Dentistry journal
Mohamed Abdelaziz El-Gamasy, Walid Ahmed El-Shehaby, Maaly M Mabrouk
Background: Cardiovascular morbidity (CVM) is the main etiology of mortality in children and adolescents with chronic kidney disease (CKD). CKD associated cardiovascular mortality is more common in children with diastolic cardiac dysfunction which was considered as an early indicator for death, while increased left ventricular mass (LVM) is a strong independent risk factor for these patients. Vitamin D deficiency was previously studied as one of the risk factors for CVM. Aim: The aim of the work was to investigate the relationship between biomarkers of mineral bone disorder including serum 25(OH) Vitamin D3 (25-OH D3), phosphorus and calcium × phosphorus (Ca×Po4) product with diastolic cardiac function and LVM in children and adolescents with CKD...
January 2019: Annals of Pediatric Cardiology
Po-Hua Huang, Tien-Hsing Chen, Yu-Sheng Lin, Su-Ju Lin, Liang-Tseng Kuo, Chi-Lung Chen, Pei-An Yu, Wei-Hsiu Hsu
There is an increased tendency for hip fractures in patients with chronic kidney disease (CKD). Although surgery is the mainstay of treatment for hip fractures, there is scant information on outcomes after hip fracture surgery in diabetic patients at different stages of CKD. In this population-based cohort study, we compared the surgical outcome, readmission, and mortality rates after osteosynthesis of hip fractures in diabetic patients with different stages of renal function. Diabetic patients who received primary osteosynthesis for hip fracture between January 1997 and December 2013 were enrolled...
February 11, 2019: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Geovanna O Pires, Itamar O Vieira, Fabiana R Hernandes, Andre L Teixeira, Ivone B Oliveira, Wagner V Dominguez, Luciene M Dos Reis, Fábio M Montenegro, Rosa M Moysés, Aluizio B Carvalho, Vanda Jorgetti
Secondary hyperparathyroidism is a complication of chronic kidney disease that compromises skeletal integrity. In patients with secondary hyperparathyroidism undergoing parathyroidectomy, parathyroid hormone levels dramatically decrease. The effects of parathyroidectomy on bone tissue are poorly understood, especially regarding the proteins expressed by osteocytes, such as fibroblast growth factor 23, dentin matrix protein 1, matrix extracellular phosphoglycoprotein, sclerostin, receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin, which regulate bone turnover...
February 6, 2019: Bone
M Oštrić, M Kukuljan, D Markić, A Gršković, A Ivančić, D Bobinac, J Španjol, J Maroević, I Šoša, T Ćelić
Since vascular calcification is considered a process regulated similar to that of bone tissue mineralization, we investigated the participation of bone formation proteins. We analyzed the correlation of serum circulating bone markers, osteoprotegerin (OPG) and receptor activator of nuclear factor ĸB ligand (RANKL) in chronic kidney disease (CKD) patients, to coronary artery calcification score. We also considered the effect of inorganic phosphate on pro- and anti-calcifying tissue factors. We confirmed that circulating OPG is an independent calcium score predictor with its high serum concentration favoring high coronary artery calcification...
February 8, 2019: Journal of Biological Regulators and Homeostatic Agents
Joana Gameiro, Inês Duarte, Cristina Outerelo, José António Lopes
Mineral bone disorder is a common feature of chronic kidney disease. Lion face syndrome is rare complication of severe hyperparathyroidism in end-stage renal disease patients, which has been less commonly reported due to dialysis and medical treatment advances in the last decade. The early recognition of the characteristic facial deformity is crucial to prompt management and prevent severe disfigurement. The authors present a rare case of severe hyperparathyroidism presenting with lion face syndrome and bone fractures...
January 21, 2019: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Sam Hobson, Samsul Arefin, Karolina Kublickiene, Paul G Shiels, Peter Stenvinkel
Together with bone-mineral disorders, premature vascular ageing is a common feature of the uremic phenotype. A detailed understanding of mechanisms involved remains unclear and warrants further research. Available treatment options for end stage renal disease are principally dialysis and organ transplantation, as other treatment alternatives have proven insufficient. Chronic kidney disease (CKD) has been proposed as a model of early vascular and bone ageing, with accumulating evidence supporting the contribution of cellular senescence and the senescence-associated secretory phenotype (SASP) to cardiovascular pathology in CKD...
February 1, 2019: Toxins
Jian Wang, Xiaobo Qiu, Tianhua Xu, Zitong Sheng, Li Yao
BACKGROUND: Abnormal mineral metabolism in patients with chronic kidney disease (CKD) may lead to vascular calcification, which is markedly associated with adverse events, including ischemic cardiac diseases and all-cause cardiovascular mortality. Thus, preventing and treating vascular calcification play an important role in improving the prognosis of CKD patients. OBJECTIVES: To investigate the potential functions of sclerostin and low-density lipoprotein receptor-related protein 4 (Lrp4) in alleviating the β-glycerophosphate (β-GP)-induced vascular smooth muscle cell (VSMC) calcification, and the protective effect of Ginkgo biloba extract (GBE)...
January 30, 2019: Blood Purification
K S Bezerra de Carvalho, R F V Vasco, M R Custodio, V Jorgetti, R M A Moysés, R M Elias
Although chronic kidney disease is associated with other bone disorders, osteoporosis can be found in this context, and it is defined based on bone mineral density (BMD), measured by dual-energy X-ray absorptiometry. As CKD progresses, the percentage of normal BMD decreases, whereas that of osteopenia/osteoporosis increases, mostly due to hip involvement, particularly in patients with reduced renal function. INTRODUCTION: Osteoporosis is a highly prevalent disease in patients with chronic kidney disease (CKD)...
January 28, 2019: Osteoporosis International
Kenichiro Iio, Daijiro Kabata, Rei Iio, Yosuke Imai, Masaki Hatanaka, Hiroki Omori, Yoshihiko Hoshida, Yukihiko Saeki, Ayumi Shintani, Takayuki Hamano, Yoshitaka Isaka, Yutaka Ando
Premature immune ageing, including thymic atrophy, is observed in patients with chronic kidney disease (CKD). Parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), which are mineral and bone disorder (MBD)-related factors, affect immune cells and possibly cause thymic atrophy. We examined the cross-sectional association between thymic atrophy, evaluated as the number of CD3+ CD4+ CD45RA+ CD31+ cells [recent thymic emigrants (RTE)/μL], and MBD-related factors [(serum PTH, FGF23, and alkaline phosphatase (ALP) level] in 125 patients with non-dialysis dependent CKD...
January 28, 2019: Scientific Reports
Aboubacar Sidibé, David Auguste, Louis-Charles Desbiens, Catherine Fortier, Yue Pei Wang, Sonia Jean, Lynne Moore, Fabrice Mac-Way
Chronic kidney disease is associated with an increased risk of fracture and cardiovascular mortality. The risk of fracture in hemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) patients is higher when compared with the general population. However, there exists a knowledge gap concerning which group has the highest risk of fracture. We aimed to compare the risk of fracture in HD, PD, and KT populations. We conducted a systematic review of observational studies evaluating the risk of fracture in HD, PD, or KT patients...
January 2019: JBMR Plus
Kazuki Kawakami, Masaki Ohya, Takashi Shigematsu
We had called the various bone disorder in chronic kidney disease(CKD)as a "ROD:renal osteodystrophy" until last decade. However the concept of ROD have changed into the chronic kidney disease-mineral and bone disease(CKD-MBD)within this decade. This concept is containing systemic disorder affected mortality. Vascular calcification is an independent risk factor for the development of cardiovascular disease and mortality. The best strategy to prevent and treat vascular calcification would consist of the CKD-MBD management...
2019: Clinical Calcium
Hironobu Fujisawa, Yosuke Nakayama, Kaoru Ueda, Kei Fukami
Abnormalities, such as hyperparathyroidism, vascular calcification, and osteoporosis, are devastating complications in patients with end-stage renal disease(ESRD). These abnormalities significantly affect the quality of life and prognosis. Therefore, controlling the abnormalities of chronic kidney disease-mineral and bone metabolism play an important role in these patients. Conventionally, calcium and phosphorus metabolism abnormalities have been mainly attributed to the development of vascular calcification, but preventing vascular calcification is still difficult even if calcium and phosphorus levels are controlled...
2019: Clinical Calcium
Hideki Fujii
Cardiovascular disease(CVD)is a crucial cause of death in patients with chronic kidney disease and various factors play a role in the progression of CVD. Among the various factors, mineral bone disorder has been focused on in recent year. Phosphate is an important factor because it affects cardiovascular system not only directly but also indirectly. Phosphate can influence the serum and cellar levels of parathyroid hormone, fibroblast growth factor 23, and active vitamin D and thereby leading to the progression of CVD...
2019: Clinical Calcium
María E Rodríguez-Ortiz, María V Pendón-Ruiz de Mier, Mariano Rodríguez
Secondary hyperparathyroidism, characterized by increased PTH synthesis and secretion, is often seen in advanced stages of chronic kidney disease. Excessive proliferation of parathyroid cells leads to the development of diffuse hyperplasia that subsequently progresses to nodular histology. Refractory hyperparathyroidism occurs when parathyroid glands fail to respond to medical therapy. Parathyroidectomy (PTX), surgical resection of parathyroid glands, is usually performed in cases of persistent serum levels of PTH above 1000 pg/mL associated with hypercalcemia or when hyperparathyroidism is refractory to conservative therapy...
January 17, 2019: Seminars in Dialysis
Cewen Liu, Hui Li
Correlation of the severity of chronic kidney disease (CKD) with serum inflammation, osteoporosis and vitamin D deficiency was investigated. A total of 78 patients suffering from CKD who presented to the Union Hospital from December 2015 to December 2017 were selected randomly and divided into three groups based on the severity of the disease. Comparisons of interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), indicators of osteoporosis [serum phosphate, serum calcium and bone mineral density (BMD)], content of 25(OH)D, serum sodium, serum potassium and BUN were conducted among groups...
January 2019: Experimental and Therapeutic Medicine
Chia-Ter Chao, Tzu-Hang Yuan, Hsiang-Yuan Yeh, Hsuan-Yu Chen, Jenq-Wen Huang, Huei-Wen Chen
Background Micro RNA -125b (miR-125b) has been shown to regulate vascular calcification ( VC ), and serum miR-125b levels are a potential biomarker for estimating the risk of uremic VC status. However, it is unknown whether clinical features, including chronic kidney disease-mineral bone disorder molecules, affect serum miR-125b levels. Methods and Results Patients receiving chronic dialysis for ≥3 months were recruited from different institutes. Serum miR-125b and chronic kidney disease-mineral bone disorder effectors, including intact parathyroid hormone, 25- OH -D, fibroblast growth factor-23, osteoprotegerin, and fetuin-A, were quantified...
January 22, 2019: Journal of the American Heart Association
Yueyi Zhou, Hao Zhang, Jian Sun, Ying Ji, Jishi Liu
Calcific uremic arteriopathy (CUA), termed calciphylaxis, is a rare but highly fatal clinical syndrome. There is no clearly laboratory diagnostic criteria for CUA. The medium and small arterial calcification and microthrombosis discovered by skin biopsy, radiologic imaging,bone scan and the evidence of activation of the bone morphogenetic protein signal (BMPs) transduction pathway are useful for early diagnosis of this disease. The common therapies (including intravenous sodium thiosulfate (STS) and bisphosphonates, hyperbaric oxygen therapy and other symptomatic supports) are used for the management of wounds, pain, nutrition, dialysis and so on...
November 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Piergiorgio Messa, Carlo Maria Alfieri
Secondary hyperparathyroidism (SHP) is a frequent complication of kidney diseases. At variance with all the other forms of SHP, which are compensatory conditions, renal SHP has many pathogenetic peculiarities, which have been only in part defined. Furthermore, in the long course of chronic kidney diseases (CKD), SHP sometimes transforms into a hypercalcemic condition resembling the autonomous form of hyperparathyroidism (tertiary hyperparathyroidism; THP). The clinical consequences of SHP in CKD patients are manifold, encompassing not only bone and mineral disorders, but also other metabolic and organic changes which frequently burden these patients...
2019: Frontiers of Hormone Research
Shunjin Hu, Dong Wang, Rui Zhang, Yuanru Cao, Hua Jin, Yanping Mao, Ling Wei, Kejun Ren, Xuelian Zhang, Yiping Wang
OBJECTIVE: To observe the effect of Ronghuang granule on serum fibroblast growth factor 23 (FGF23), fibroblast growth factor receptor (FGFRs) and Klotho protein levels in non-dialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and kidney deficiency and damp heat syndrome. METHODS: Seventy non-dialysis CKD-MBD patients with kidney deficiency and dampness-heat syndrome were randomized into control group ( n =35) and treatment group ( n =35)...
December 30, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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