Pathophysiology of bone disease in chronic kidney disease : from basics to renal osteodystrophy and osteoporosis
Aguilar, Armando (IMSS General Hospital of Zone No 2. Mexican Social Security)
Gifre, Laia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ureña-Torres, Pablo (University of Paris Descartes)
Carrillo-López, Natalia (Instituto de Investigación Sanitaria del Principado de Asturias)
Rodriguez-García, Minerva (Hospital Universitario Central Asturias)
Massó, Elisabeth (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Da Silva, Iara (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
López-Báez, Víctor Alfonso (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sánchez-Baya, Maya (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Prior-Español, Águeda (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Urrutia, Marina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Paul, Javier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bustos, Misael C. (Pontificia Catholic University of Chile)
Vila Santandreu, Anna (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Garnica-León, Isa (IMSS General Hospital of Zone No 2. Mexican Social Security)
Navarro-González, Juan F. (Universidad de La Laguna)
Mateo, Lourdes (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bover, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Chronic kidney disease (CKD) is a highly prevalent disease that has become a public health problem. Progression of CKD is associated with serious complications, including the systemic CKD-mineral and bone disorder (CKD-MBD). Laboratory, bone and vascular abnormalities define this condition, and all have been independently related to cardiovascular disease and high mortality rates. The "old" cross-talk between kidney and bone (classically known as "renal osteodystrophies") has been recently expanded to the cardiovascular system, emphasizing the importance of the bone component of CKD-MBD. Moreover, a recently recognized higher susceptibility of patients with CKD to falls and bone fractures led to important paradigm changes in the new CKD-MBD guidelines. Evaluation of bone mineral density and the diagnosis of "osteoporosis" emerges in nephrology as a new possibility "if results will impact clinical decisions". Obviously, it is still reasonable to perform a bone biopsy if knowledge of the type of renal osteodystrophy will be clinically useful (low versus high turnover-bone disease). However, it is now considered that the inability to perform a bone biopsy may not justify withholding antiresorptive therapies to patients with high risk of fracture. This view adds to the effects of parathyroid hormone in CKD patients and the classical treatment of secondary hyperparathyroidism. The availability of new antiosteoporotic treatments bring the opportunity to come back to the basics, and the knowledge of new pathophysiological pathways [OPG/RANKL (LGR4); Wnt-ß-catenin pathway], also affected in CKD, offers great opportunities to further unravel the complex physiopathology of CKD-MBD and to improve outcomes.
Drets:	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.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adynamic bone disease ; CKD-MBD ; Osteoporosis ; Parathyroid hormone ; RANKL (receptor activator for nuclear factor k B ligand) ; Renal osteodystrophy ; Sclerostin ; Wnt
Publicat a:	Frontiers in physiology, Vol. 14 (june 2023) , ISSN 1664-042X

DOI: 10.3389/fphys.2023.1177829
PMID: 37342799

17 p, 1.5 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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