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Negri AL, Barone R, Quiroga MA, Bravo M, Marino A, Fradinger E, Bogado CE, Zanchetta JR. Bone Mineral Density: Serum Markers of Bone Turnover and Their Relationships in Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080402400207] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The usefulness of bone mass measurements and bone turnover markers to estimate the risk of fracture and the type of underlying renal osteodystrophy are not well established in patients on peritoneal dialysis (PD). Objective To assess bone mass using total and regional bone densitometry in a group of patients on PD and to determine if serum markers of bone turnover identify patients with low bone mass. Methods Bone densitometry was studied by dual-energy x-ray absorptiometry (DEXA), and bone turnover using several serum markers, in 65 patients on PD. Bone mass was classified as normal, osteopenic, or osteoporotic according to World Health Organization criteria based on bone mineral density (BMD) T scores. Results T scores in the osteopenia range were present at the lumbar spine (LS) in 44.6% (45% of men and 44.4% of women) of patients and at the femoral neck (FN) in 56.9% (55% of men and 58% of women). T scores in the osteoporosis range were present at the LS in 13.8% of patients (10% of men and 15.5% of women) and at the FN in 21.5% (30% of men and 17.7% of women). Patients with BMD T scores in the osteoporosis range at both regions had increased serum intact parathyroid hormone (iPTH) levels compared to patients in the osteopenic/normal range. Bone mineral content in the whole skeleton (TBMC) correlated negatively with iPTH ( r = –0.34) and with total time on dialysis ( r = –0.26); in multivariate analysis, only iPTH correlated negatively with TBMC ( B = –0.26, p = 0.03). No correlations were found between the other bone markers and BMD T scores at the FN or LS. There were no significant differences in absolute BMD or BMD T scores at the LS or FN between patients with and patients without fractures. Conclusions BMD T scores in the osteopenia/osteoporosis range were observed at the LS in 58.4% of these patients on PD and at the FN in 78.4%. TBMC correlated negatively with iPTH. There were no correlations between markers of bone turnover and bone mass measurements at the two skeletal regions, although patients with BMD T scores in the osteoporosis range had increased serum iPTH levels. Bone mass measurements were not different between patients with and patients without fractures.
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Affiliation(s)
- Armando L. Negri
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Roberto Barone
- Servicio de Terapia Renal Hurlingham SRL, Buenos Aires, Argentina
| | | | - Marina Bravo
- Fresenius Medical Care Argentina Caballito, Buenos Aires, Argentina
| | - Alicia Marino
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Erich Fradinger
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Cesar E. Bogado
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
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Tao S, Bai Y, Zhou X, Zhao J, Yang H, Zhang S, Wang J. In Vitro Fermentation Characteristics for Different Ratios of Soluble to Insoluble Dietary Fiber by Fresh Fecal Microbiota from Growing Pigs. ACS OMEGA 2019; 4:15158-15167. [PMID: 31552361 PMCID: PMC6751720 DOI: 10.1021/acsomega.9b01849] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
This study was conducted to explore the in vitro fermentation characteristics for different ratios of soluble to insoluble dietary fiber in pig fecal microbiota. The fermentation substrates consisted of inulin and a non-starch polysaccharide mixture and were divided into five groups according to different soluble dietary fiber (SDF) to insoluble dietary fiber (IDF) ratios (SDF 25, 50, 75, and 100%). With the increased SDF ratio, the total gas production increased, and the pH in the substrate decreased as the fermentation proceeded. The concentrations of lactic acid, formic acid, and acetic acid increased in the high SDF ratio group, whereas the concentrations of propionic acid and butyric acid increased in the low SDF ratio group. The genera Clostridium_sensu_stricto_1, Ruminococcaceae_NK4A214_group, Christensenellaceae_R-7_group, and Rikenellaceae_RC9_gut_group were enriched in the high SDF ratio group. Correlation analysis indicated that these differential bacteria had the potential to degrade polysaccharides. These results revealed that high SDF ratios could stimulate the proliferation of fibrolytic bacteria, which in turn degrade fibers to produce organic acids and monosaccharides. Collectively, these findings add to our understanding of the mechanisms responsible for interaction between SDF and intestinal microbiota and provide new ideas for the rational use of dietary fiber.
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Boonpheng B, Thongprayoon C, Mao MA, Wijarnpreecha K, Bathini T, Kaewput W, Ungprasert P, Cheungpasitporn W. Risk of hip fracture in patients on hemodialysis versus peritoneal dialysis: A meta-analysis of observational studies. J Evid Based Med 2019; 12:98-104. [PMID: 30701673 DOI: 10.1111/jebm.12341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 12/31/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bone and mineral metabolism disorders are common among end-stage renal disease (ESRD) patients, which could lead to hip fracture. It is unclear whether the hip fracture risk is different among patients on hemodialysis (HD) versus peritoneal dialysis (PD). This meta-analysis was conducted to evaluate the hip fracture risk in ESRD patients on HD, when compared to PD. METHODS A literature review was conducted in EMBASE, MEDLINE, and Cochrane databases through January 31, 2018 to identify studies that appraised the rate or risk of hip fracture among patients on HD, when compared to PD. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, generic inverse variance approach of DerSimonian and Laird. RESULTS Five cohort studies with 1 276 677 ESRD patients were enrolled. HD status was associated with a significantly higher risk of hip fracture with the pooled odds ratio (OR) of 1.61 (95% confidence interval [CI] 1.50-1.73, I2 = 10.0%), compared with PD. When the analysis was limited to studies with confounder-adjusted analysis, the pooled OR of hip fracture among HD patients was 1.57 (95% CI 1.43-1.72, I2 = 13.6%). Funnel plots and Egger's regression test demonstrated no significant publication bias in our meta-analysis. CONCLUSIONS Among ESRD patients, HD status is associated with a 61% higher risk of hip fracture compared to PD.
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Affiliation(s)
- Boonphiphop Boonpheng
- Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee
| | - Charat Thongprayoon
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael A Mao
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Jacksonville, Florida
| | - Tarun Bathini
- Department of Internal Medicine, University of Arizona, Tucson, Arizona
| | - Wisit Kaewput
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Patompong Ungprasert
- Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wisit Cheungpasitporn
- Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
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Calcium-Phosphate Metabolism Disorders in Patients with Renal Failure Clinical Significance, Diagnosis and Treatment. ACTA MEDICA BULGARICA 2019. [DOI: 10.2478/amb-2019-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Chronic kidney diseases (CKD) are commonly associated with calcium and phosphorus metabolism disorders. The general term of “renal osteodystrophy” (ROD) encompasses a complex spectrum of abnormalities in bone and mineral metabolism in CKD. This is one of the most serious and debilitating complications of CKD. It is related to disproportionately high direct and indirect costs of healthcare, thus posing a major burden on society. The development of ROD begins too early in the course of CKD. Some mechanisms involved in the pathogenesis of ROD are reduced calciferol production, calcium deficiency and hyperphosphatemia. Clinically, ROD occurs with varied manifestations – osteomalacia, osteoporosis, adynamic bone disease. The diagnosis and the treatment are a challenge for the physician and effort should be made to prolong the duration and quality of life of the affected patients.
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Nybo M, Jespersen B, Aarup M, Ejersted C, Hermann AP, Brixen K. Determinants of bone mineral density in patients on haemodialysis or peritoneal dialysis--a cross-sectional, longitudinal study. Biochem Med (Zagreb) 2013; 23:342-50. [PMID: 24266305 PMCID: PMC3900080 DOI: 10.11613/bm.2013.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 09/16/2013] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The aim of the study was to identify biomarkers of alteration in bone mineral density (BMD) in patients on haemodialysis (HD) and peritoneal dialysis (PD). MATERIALS AND METHODS In a cross-sectional, longitudinal study dual-energy X-ray absorptiometry scans were performed in 146 HD-patients and 28 PD-patients. Follow-up after 14 months (mean) was conducted in 73 patients. As potential biomarkers we investigated parathyroid hormone (PTH), 25-hydroxy vitamin-D, ionised calcium, albumin, phosphate, and total alkaline phosphatases (t-ALP). RESULTS Both groups of dialysis patients had lower BMD in the femoral neck (BMD(neck)) (P < 0.001) and forearm (BMD(forearm)) (P < 0.001) compared to healthy controls, but comparable BMD in the lumbar spine (BMD(spine)). BMD did not differ between dialysis types, but patients ever-treated with glucocorticoids had significantly lower BMD, while patients with polycystic kidney disease had higher BMD. BMD correlated with body weight, actual age, age at initiation of dialysis, duration of dialysis and levels of PTH and t-ALP. However, t-ALP only remained associated with low BMD(spine) after adjusting for other factors (P = 0.001). In the follow-up study all patients had decreased BMD in all three locations, but only for the lumbar spine there was a significant association between BMD and the bone markers t-ALP (P = 0.009) and PTH (P = 0.013). CONCLUSIONS Both HD and PD patients have low BMD, and increased concentrations of t-ALP is associated BMD(spine) after adjustment, while PTH and t-ALP is associated with decrease in BMD(spine) over time. This substantiates the use of these biomarkers in both types of dialysis patients.
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Affiliation(s)
- Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark.
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Ambrus C, Marton A, Nemeth ZK, Mucsi I. Bone mineral density in patients on maintenance dialysis. Int Urol Nephrol 2009; 42:723-39. [DOI: 10.1007/s11255-009-9666-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 10/13/2009] [Indexed: 01/09/2023]
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Haarhaus M, Fernström A, Magnusson M, Magnusson P. Clinical significance of bone alkaline phosphatase isoforms, including the novel B1x isoform, in mild to moderate chronic kidney disease. Nephrol Dial Transplant 2009; 24:3382-9. [PMID: 19542194 DOI: 10.1093/ndt/gfp300] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mineral bone disorder (MBD) is a common complication of chronic kidney disease (CKD) even during the early stages. Bone alkaline phosphatase (BALP) is a marker of bone formation and plays a pivotal role in the mineralization process. Three BALP isoforms (B/I, B1 and B2) have been identified in healthy individuals and a fourth isoform (B1x) has been discovered in serum from dialysis patients. We investigated these BALP isoforms, type I procollagen intact amino-terminal propeptide (PINP), carboxy-terminal telopeptide of type I collagen (CTX) and tartrate-resistant acid phosphatase isoform 5b (TRACP5b), as well as bone mineral density (BMD) in predialysis CKD patients. METHODS PINP, CTX, TRACP5b and BALP isoforms were analysed in serum from 46 patients within CKD stages 3-5. BMD was determined by dual-energy x-ray absorptiometry. RESULTS PINP, TRACP5b and the BALP isoforms, B/I, B1 and B2, were independent predictors of total hip BMD in all patients. Furthermore, B/I predicted osteopaenia in the hip and in the distal 1/3 of the radius in CKD stage 3. The B1x isoform was detected in nine patients (20%), who had lower GFR, higher phosphate and calcium x phosphate product. CONCLUSION We found an association of BALP isoforms and other markers of bone turnover with total hip BMD, which predominantly comprises trabecular bone. The association of the new BALP isoform B1x with risk factors for vascular calcification leads us to hypothesize a possible role for B1x in this process. The significance of the BALP isoforms in CKD remains to be further explored in experimental and clinical settings in conjunction with bone histomorphometry.
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Affiliation(s)
- Mathias Haarhaus
- Department of Nephrology, Linköping University Hospital, Division of Clinical Chemistry, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden.
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OTT SUSANM. Review article: Bone density in patients with chronic kidney disease stages 4-5. Nephrology (Carlton) 2009; 14:395-403. [DOI: 10.1111/j.1440-1797.2009.01159.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Doumouchtsis KK, Kostakis AI, Doumouchtsis SK, Tziamalis MP, Stathakis CP, Diamanti-Kandarakis E, Dimitroulis D, Perrea DN. Associations between osteoprotegerin and femoral neck BMD in hemodialysis patients. J Bone Miner Metab 2008; 26:66-72. [PMID: 18095066 DOI: 10.1007/s00774-007-0785-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Accepted: 06/21/2007] [Indexed: 11/29/2022]
Abstract
Numerous humoral factors are involved in the development of renal osteodystrophy, causing perturbations in bone mineral density (BMD) in patients with end-stage renal disease (ESRD). The RANKL/OPG cytokine system appears to mediate the effects of many of these factors on bone turnover, contributing to the pathogenesis of renal bone disease. The aim of this study was to evaluate the clinical and biochemical correlations of BMD measurements in patients on chronic hemodialysis. Fifty-four hemodialysis patients underwent measurement of BMD at the proximal femur and the lumbar spine (L2-L4). Intact parathyroid hormone (PTH), osteoprotegerin (OPG), sRANKL, and main bone biochemical markers were also measured in serum samples of all patients. BMD of the femoral neck was negatively correlated with OPG levels (r = 0.333, P = 0.014). OPG levels were significantly different among normal, osteopenic, and osteoporotic tertiles defined according to BMD of the femoral neck. The highest OPG levels were measured in the lowest T-score (osteoporotic) tertile and were higher than in the osteopenic and normal tertiles (P < 0.05). A threshold level for OPG at 21.5 pmol/l enabled the detection of osteoporotic patients with 76.5% sensitivity and 62.2% specificity. BMD values of trabecular bone-rich sites of the skeleton such as lumbar spine (L2-L4), trochanter, and Ward' s triangle were inversely correlated with total ALP levels (P < 0.05). Hemodialysis patients with low BMD of the femoral neck demonstrated higher OPG levels than patients with normal BMD. Those with lumbar spine (L2-L4), trochanteric, and Ward's triangle BMDs below the normal range presented higher total ALP levels. These results suggest that OPG and total ALP may be clinically useful markers in the detection of significant femoral neck and trabecular bone mineral deficit in hemodialysis patients, warranting further investigations.
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Affiliation(s)
- Konstantinos K Doumouchtsis
- Laboratory for Experimental Surgery and Surgical Research, Athens University, 15B Saint Thomas Street, Athens 11527, Greece.
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Sit D, Kadiroglu AK, Kayabasi H, Atay AE, Yilmaz Z, Yilmaz ME. Relationship between bone mineral density and biochemical markers of bone turnover in hemodialysis patients. Adv Ther 2007; 24:987-95. [PMID: 18029324 DOI: 10.1007/bf02877703] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
End-stage renal disease is closely associated with changes in bone and mineral metabolism. In recent times, osteoporosis has become important among hemodialysis (HD) patients. In this study, the investigators sought to evaluate the relationship between bone mineral density (BMD) and biochemical markers of bone turnover among HD patients. A total of 70 uremic patients on a maintenance HD program for at least 1 y were enrolled in the study. All patients were treated with conventional bicarbonated HD for 5 h through the use of low-flux hollow-fiber dialyzers. Bone densitometry was measured by dual energy x-ray absorptiometry in the lumbar spine (LS) and the femoral neck (FN). BMD was classified according to World Health Organization criteria on the basis of BMD T scores. Biochemical bone turnover markers such as calcium, phosphorus, ionized calcium, intact parathyroid hormone, alkaline phosphatase, plasma bicarbonate, blood pH, serum albumin, and hematocrit levels were measured before the HD session in the morning. Male patients (n=37; 52.9%; mean age, 46.2+/-17.0 y) were assigned to a single study group, and female patients (n=33; 47.1%; mean age, 44.0+/-13.1 y) to another. Mean duration of HD treatment was 33.7+/-28.5 mo in females and 33.0+/-26.0 mo in males. Among all patients, BMD T scores in the osteopenia/osteoporosis range were observed at the LS in 58 patients (82.8%) and at the FN in 45 patients (64.3%). According to BMD measurements in FN T score, 10% of patients (n=7) were osteoporotic, 54.3% (n=38), osteopenic, and 35.7% (n=25), normal. On the other hand, in LS T score, the results were 47.1% (n=33) osteoporotic, 35.7% (n=25), osteopenic, and 17.1% (n=12), normal. No statistically significant association was found in osteopenia/osteoporosis between sexes according to FN and LS T score (P=.542, P=.267, respectively). No significant relationship was noted between BMD and biochemical markers of bone turnover. A positive correlation was found between FN T scores of BMD and age (r=.413, P=.000). BMD T scores within the range of scores for osteopenia/osteoporosis were observed in 78.5% of patients at the LS and in 58.5% of patients at the FN. The investigators concluded that no correlation could be found between markers of bone turnover and bone mass measurements in both skeletal regions. LS T score results were worse than FN T score results. Elevated alkaline phosphastase levels combined with high intact parathyroid hormone levels are predictive of renal osteodystrophy but not of adynamic bone disease/osteoporosis.
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Affiliation(s)
- Dede Sit
- Department of Nephrology, Dicle University Medical Faculty, Diyarbakir, Turkey.
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Rahmant AMOA, . SAFE, . IZEH, . MAR. C-terminal Propeptide of Type-I Procollagen as a Possible Biochemical Marker for Preclinical Detection of Cardiac Disease in Chronic Renal Failure. JOURNAL OF MEDICAL SCIENCES 2007. [DOI: 10.3923/jms.2007.804.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Comparison of Biochemical Markers of Bone Turnover in Patients on Continuous Ambulatory Peritoneal Dialysis and Maintenance Hemodialysis. J Med Biochem 2007. [DOI: 10.2478/v10011-007-0025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Comparison of Biochemical Markers of Bone Turnover in Patients on Continuous Ambulatory Peritoneal Dialysis and Maintenance HemodialysisThe aim of this study was to compare the biochemical markers of bone formation - bone isoenzyme alkaline phosphatase, /BALP/ bone resorption - tartarat resistant acid phosphatase /TRAP/ and parameters of bone turnover (Ca, P and iPTH) between 108 patients on continuous ambulatory peritoneal dialysis (CAPD) and 112 patients on hemodialysis (HD). Parameters were determined by spectrophotometry (TRAP, Ca, P), electrochemiluminiscent method (iPTH) and electrophoresis (BALP). There was significant correlation between BALP levels of CAPD patients and Ca values of HD patients (r = 0.216, p < 0.05), but comparison of P, iPTH and BALP showed no significant difference between the groups. We found significant correlation between BALP and TRAP (r = 0.570, p < 0.01) and BALP and iPTH values (r = 0.551, p < 0.01) in HD patients. Also, significant correlations in CAPD patients between BALP and TRAP (r = 0.194, p < 0.05) and BALP and iPTH values (r = 0.283, p < 0.01) were found. Our results suggest that the effect of CAPD and HD on bone turnover may be monitored most conclusively via BALP levels. This biochemical marker is a very good index of bone turnover in patients undergoing dialysis and it could indicate an early stage of decreased bone turnover.
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Negri AL, Barone R, Lombas C, Bogado CE, Zanchetta JR. Evaluation of cortical bone by peripheral quantitative computed tomography in continuous ambulatory peritoneal dialysis patients. Hemodial Int 2006; 10:351-5. [PMID: 17014510 DOI: 10.1111/j.1542-4758.2006.00128.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several studies have suggested an increased prevalence of osteopenia in dialysis. Peripheral quantitative computed tomography (pQCT) is a new technique that allows the noninvasive evaluation of trabecular and cortical bone separately. The aim of the study was: (1) to evaluate cortical bone by pQCT in continuous ambulatory peritoneal dialysis (CAPD) patients and compare the data with that obtained in healthy controls; and (2) to correlate cortical bone parameters with bone mineral density (BMD) of the lumbar spine and femoral neck and total bone mineral content (TBMC). Cortical bone parameters were obtained in 22 CAPD patients and 27 healthy individuals at the distal radius using a Stratec XCT 960 pQCT machine. In the dialysis patients, we also determined BMD and TBMC by bone densitometry. Dialysis patients, compared with controls, showed a significant reduction in volumetric cortical BMD (VcBMD) (p = 0.04) and cortical thickness (cThk) (p < 0.0001) with a significant increase in radial total cross-sectional area (TA) (p = 0.006), endosteal circumference (p < 0.0001), and buckling ratio (p < 0.0001). In CAPD patients, total time on dialysis correlated negatively with radial total BMD (p < 0.01) and VcBMD (p < 0.01). Age correlated positively with TA (p < 0.01), endosteal (p < 0.01), and periosteal circumferences (p < 0.01). Serum intact parathyroid hormone (PTH) levels correlated positively with endosteal (p = 0.04) and periosteal perimeter (p = 0.01). Total alkaline phosphatase correlated negatively with VcBMD (p < 0.01), and positively with endosteal perimeter (p = 0.02). Total bone mineral content correlated significantly with radial cortical content (p < 0.001), cross-sectional cortical area (cA; p < 0.001), and cThk (p < 0.01) but not with total radial BMD, VcBMD, or buckling ratio. No correlations were found between radial cortical parameters and BMD measured at the lumbar spine or femoral neck. We conclude that dialysis patients show cortical osteopenia with marked cortical thinning partially mediated by PTH action on bone. Total bone mineral content correlated with various radial cortical parameters (content, area, and thickness) but not with others. No correlations were found between cortical bone parameters measured at the peripheral skeleton with areal bone density measured at the axial skeleton. These findings suggest that pQCT may be a new tool in the assessment of bone fragility in dialysis patients.
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Weiler H, Austin S, Fitzpatrick-Wong S, Nitschmann E, Bankovic-Calic N, Mollard R, Aukema H, Ogborn M. Conjugated linoleic acid reduces parathyroid hormone in health and in polycystic kidney disease in rats. Am J Clin Nutr 2004; 79:1186S-1189S. [PMID: 15159255 DOI: 10.1093/ajcn/79.6.1186s] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Feeding conjugated linoleic acid (CLA) is reported to reduce prostaglandin E(2) synthesis, which is required for parathyroid hormone (PTH) release. OBJECTIVE This study was undertaken to determine whether CLA would suppress hyperparathyroidism and the resulting high-turnover bone disease in a rat model of polycystic kidney disease (PKD). DESIGN Outcome measurements were conducted after 8 wk of feeding diets supplemented with and without CLA (1% of dietary fat) to Han:SPRD-cy male rats (n = 52). PTH, bone formation, and resorption were assessed in addition to femur bone mass with use of dual-energy X-ray absorptiometry. RESULTS CLA feeding resulted in attenuation of PTH concentrations in both PKD-affected and nonaffected rats (by 60%) but did not significantly alter bone formation and resorption. CONCLUSION Reduction in PTH may open possibilities for CLA as an adjunctive therapy in secondary hyperparathyroidism.
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Affiliation(s)
- Hope Weiler
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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