Evaluating Osteoporosis in Chronic Kidney Disease : Both Bone Quantity and Quality Matter
Lloret, Maria Jesus (Institut de Recerca Sant Pau)
Fusaro, Maria (University of Padua)
Jørgensen, Hanne S. (Aalborg University Hospital (Dinamarca))
Haarhaus, Mathias (Diaverum AB)
Gifre, Laia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Alfieri, Carlo Maria (University of Milan)
Massó, Elisabet (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
D'Marco, Luis (Universidad CEU Cardenal Herrera)
Evenepoel, Pieter (KU Leuven)
Bover, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Bone strength is determined not only by bone quantity [bone mineral density (BMD)] but also by bone quality, including matrix composition, collagen fiber arrangement, microarchitecture, geometry, mineralization, and bone turnover, among others. These aspects influence elasticity, the load-bearing and repair capacity of bone, and microcrack propagation and are thus key to fractures and their avoidance. In chronic kidney disease (CKD)-associated osteoporosis, factors traditionally associated with a lower bone mass (advanced age or hypogonadism) often coexist with non-traditional factors specific to CKD (uremic toxins or renal osteodystrophy, among others), which will have an impact on bone quality. The gold standard for measuring BMD is dual-energy X-ray absorptiometry, which is widely accepted in the general population and is also capable of predicting fracture risk in CKD. Nevertheless, a significant number of fractures occur in the absence of densitometric World Health Organization (WHO) criteria for osteoporosis, suggesting that methods that also evaluate bone quality need to be considered in order to achieve a comprehensive assessment of fracture risk. The techniques for measuring bone quality are limited by their high cost or invasive nature, which has prevented their implementation in clinical practice. A bone biopsy, high-resolution peripheral quantitative computed tomography, and impact microindentation are some of the methods established to assess bone quality. Herein, we review the current evidence in the literature with the aim of exploring the factors that affect both bone quality and bone quantity in CKD and describing available techniques to assess them.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Bone mineral density ; Bone quality ; Chronic kidney disease ; Densitometry ; DXA ; Fractures ; Osteoporosis
Published in:	Journal of clinical medicine, Vol. 13 (february 2024) , ISSN 2077-0383

DOI: 10.3390/jcm13041010
PMID: 38398323

18 p, 1.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles