Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure - PubMed (original) (raw)
Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure
M Rix et al. Kidney Int. 1999 Sep.
Free article
Abstract
Background: Metabolic bone disease might commence early in the course of renal failure. This study therefore examined the frequency and severity of the skeletal changes in predialysis chronic renal failure by measurements of bone mineral density (BMD), biochemical markers of bone turnover (osteocalcin, bone-specific alkaline phosphatase, carboxy terminal propeptide of type I collagen, and carboxy-terminal telopeptide of type I collagen), parathyroid hormone (PTH), ionized calcium (Ca++), phosphate (P), and vitamin D metabolites.
Methods: The study was performed in 113 patients (male/female: 82/31) with chronic renal diseases [mean glomerular filtration rate (GFR) of 37 ml/min] and in 89 matched, normal control subjects.
Results: The patients had significantly (P<0.05) reduced BMD in the spine (-6.3%), the femur (-12.1%), the forearm (-5.7%), and the total body (-4.2%) as compared with the control subjects. Dividing the patients into quartiles according to GFR revealed that BMD decreased with the gradual decline in renal function at all the measured skeletal sites, but was most pronounced in the femur: 0.63+/-0.03, 0.74+/-0.02, 0.77+/-0.02, and 0.82+/-0.03 g/cm2 in each quartile from lowest to highest GFR compared with 0.82+/-0.02 g/cm2 in the control group (P<0.0001). All of the measured bone markers showed increasing plasma levels with the more advanced stages of renal failure. Serum PTH and serum P levels increased, whereas serum Ca++ and 1,25-dihydroxyvitamin D decreased. BMD Z-scores of the femur and of the forearm correlated to the biochemical markers and to PTH (P<0.05 to P<0.0001). The biochemical markers all showed strong correlations to PTH, also when corrected for the effect of the decline in GFR (r = 0.40 to 0.92, P<0.01 to P< 0.0001).
Conclusion: Skeletal changes are initiated at an early stage of chronic renal failure, as estimated from reduced BMD and elevated levels of PTH and from the biochemical markers of both bone formation and bone resorption.
Similar articles
- Studies on bone markers and bone mineral density in patients with chronic renal failure.
Ha SK, Park CH, Seo JK, Park SH, Kang SW, Choi KH, Lee HY, Han DS. Ha SK, et al. Yonsei Med J. 1996 Oct;37(5):350-6. doi: 10.3349/ymj.1996.37.5.350. Yonsei Med J. 1996. PMID: 8997167 - [Changes in mineral metabolism in stage 3, 4, and 5 chronic kidney disease (not on dialysis)].
Lorenzo Sellares V, Torregrosa V. Lorenzo Sellares V, et al. Nefrologia. 2008;28 Suppl 3:67-78. Nefrologia. 2008. PMID: 19018742 Spanish. - Bone mineral density and biochemical markers of bone metabolism in predialysis patients with chronic kidney disease.
Fidan N, Inci A, Coban M, Ulman C, Kursat S. Fidan N, et al. J Investig Med. 2016 Apr;64(4):861-6. doi: 10.1136/jim-2015-000043. Epub 2016 Mar 11. J Investig Med. 2016. PMID: 26969749 - Prevention of metabolic bone disease in the pre-end-stage renal disease setting.
Coburn JW, Elangovan L. Coburn JW, et al. J Am Soc Nephrol. 1998 Dec;9(12 Suppl):S71-7. J Am Soc Nephrol. 1998. PMID: 11443772 Review. - [K/DOQI clinical practice guidelines for management of renal osteodystrophy in predialysis patients].
Okada N, Tsubakihara Y. Okada N, et al. Clin Calcium. 2004 May;14(5):698-706. Clin Calcium. 2004. PMID: 15577030 Review. Japanese.
Cited by
- Evaluating Osteoporosis in Chronic Kidney Disease: Both Bone Quantity and Quality Matter.
Lloret MJ, Fusaro M, Jørgensen HS, Haarhaus M, Gifre L, Alfieri CM, Massó E, D'Marco L, Evenepoel P, Bover J. Lloret MJ, et al. J Clin Med. 2024 Feb 9;13(4):1010. doi: 10.3390/jcm13041010. J Clin Med. 2024. PMID: 38398323 Free PMC article. Review. - Consensus Evidence-Based Clinical Practice Recommendations for the Diagnosis and Treat-To-Target Management of Osteoporosis in Chronic Kidney Disease Stages G4-G5D and Post-transplantation: An Initiative of Egyptian Academy of Bone Health.
El Miedany Y, Gadallah NA, Sarhan E, Toth M, Hasab El Naby MM, Elwy M, Ganeb S, El Gaafary M, Mortada M, Nasef SI, Mohannad N, Mahran SA, Abu-Zaid MH, Eissa M, Hassan W, Medhat BM, Ghaleb R, Tabra SA, Saber HG, Ibrahim RA, Saber S, Galal S. El Miedany Y, et al. Kidney Dis (Basel). 2022 Oct 31;8(5):392-407. doi: 10.1159/000526492. eCollection 2022 Nov. Kidney Dis (Basel). 2022. PMID: 36466074 Free PMC article. - Relationship between Nutrition-Related Problems and Falls in Hemodialysis Patients: A Narrative Review.
Shirai N, Inoue T, Ogawa M, Okamura M, Morishita S, Suguru Y, Tsubaki A. Shirai N, et al. Nutrients. 2022 Aug 6;14(15):3225. doi: 10.3390/nu14153225. Nutrients. 2022. PMID: 35956401 Free PMC article. Review. - Managing Musculoskeletal and Kidney Aging: A Call for Holistic Insights.
Cailleaux PE, Cohen-Solal M. Cailleaux PE, et al. Clin Interv Aging. 2022 May 4;17:717-732. doi: 10.2147/CIA.S357501. eCollection 2022. Clin Interv Aging. 2022. PMID: 35548383 Free PMC article. Review. - Vitamin D Analogues and Fracture Risk in Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Khelifi N, Desbiens LC, Sidibé A, Mac-Way F. Khelifi N, et al. JBMR Plus. 2022 Feb 21;6(4):e10611. doi: 10.1002/jbm4.10611. eCollection 2022 Apr. JBMR Plus. 2022. PMID: 35434454 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical