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Molecular Abnormalities Underlying Bone Fragility in Chronic Kidney Disease.

Abstract Prevention of bone fractures is one goal of therapy for patients with chronic kidney disease-mineral and bone disorder (CKD-MBD), as indicated by the Kidney Disease: Improving Global Outcomes guidelines. CKD patients, including those on hemodialysis, are at higher risk for fractures and fracture-related death compared to people with normal kidney function. However, few clinicians focus on this issue as it is very difficult to estimate bone fragility. Additionally, uremia-related bone fragility has a more complicated pathological process compared to osteoporosis. There are many uremia-associated factors that contribute to bone fragility, including severe secondary hyperparathyroidism, skeletal resistance to parathyroid hormone, and bone mineralization disorders. Uremia also aggravates bone volume loss, disarranges microarchitecture, and increases the deterioration of material properties of bone through abnormal bone cells or excess oxidative stress. In this review, we outline the prevalence of fractures, the interaction of CKD-MBD with osteoporosis in CKD patients, and discuss possible factors that exacerbate the mechanical properties of bone.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title biomed research international
Publication Year Start




PMID- 28421193
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170423
IS  - 2314-6141 (Electronic)
VI  - 2017
DP  - 2017
TI  - Molecular Abnormalities Underlying Bone Fragility in Chronic Kidney Disease.
PG  - 3485785
LID - 10.1155/2017/3485785 [doi]
AB  - Prevention of bone fractures is one goal of therapy for patients with chronic
      kidney disease-mineral and bone disorder (CKD-MBD), as indicated by the Kidney
      Disease: Improving Global Outcomes guidelines. CKD patients, including those on
      hemodialysis, are at higher risk for fractures and fracture-related death
      compared to people with normal kidney function. However, few clinicians focus on 
      this issue as it is very difficult to estimate bone fragility. Additionally,
      uremia-related bone fragility has a more complicated pathological process
      compared to osteoporosis. There are many uremia-associated factors that
      contribute to bone fragility, including severe secondary hyperparathyroidism,
      skeletal resistance to parathyroid hormone, and bone mineralization disorders.
      Uremia also aggravates bone volume loss, disarranges microarchitecture, and
      increases the deterioration of material properties of bone through abnormal bone 
      cells or excess oxidative stress. In this review, we outline the prevalence of
      fractures, the interaction of CKD-MBD with osteoporosis in CKD patients, and
      discuss possible factors that exacerbate the mechanical properties of bone.
FAU - Iwasaki, Yoshiko
AU  - Iwasaki Y
AD  - Department of Health Sciences, Oita University of Nursing and Health Sciences,
      Oita, Japan.
FAU - Kazama, Junichiro James
AU  - Kazama JJ
AD  - Department of Nephrology and Hypertension, Fukushima Medical University,
      Fukushima, Japan.
FAU - Fukagawa, Masafumi
AU  - Fukagawa M
AUID- ORCID: 0000-0002-7832-2339
AD  - Division of Nephrology and Metabolism, Tokai University School of Medicine,
      Kanagawa, Japan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170322
PL  - United States
TA  - Biomed Res Int
JT  - BioMed research international
JID - 101600173
PMC - PMC5380833
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
PHST- 2016/10/31 [received]
PHST- 2017/02/28 [revised]
PHST- 2017/03/13 [accepted]
AID - 10.1155/2017/3485785 [doi]
PST - ppublish
SO  - Biomed Res Int. 2017;2017:3485785. doi: 10.1155/2017/3485785. Epub 2017 Mar 22.

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