Abstract：
:Osteoporosis and chronic kidney disease (CKD) have both independently important potential impact on bone health. A significant number of patients with CKD stages 3a-5D have been shown to have low bone mineral density (BMD), leading to a strikingly elevated risk of fractures (mainly hip fractures) and higher associated morbidity and mortality. Mechanical properties of bone beyond age and menopausal status are additionally affected by intrinsic uremic factors. Therefore, we review in this article not only general concepts of osteoporosis and related consequences, but also the diagnostic and therapeutic implications of low BMD and bone fractures in CKD, beyond increased vascular calcification. Antiresorptive agents (mainly bisphosphonates) were not previously recommended when the estimated glomerular filtration rate (GFR) was lower than 30 ml/min/1.73 m2. However, post-hoc analysis of large randomized clinical trials found that these drugs (i.e. alendronate, ribandronate, denosumab) had comparable efficacy in improving BMD and reducing fracture risk in individuals (mainly women) with moderate reductions of GFR (mostly CKD stages 3-4). Therefore, at least in the absence of clear abnormalities of CKD-related mineral metabolism disturbances, bone antiresorptive agents (and maybe anabolic agents) that are or will be approved for general osteoporosis may be appropriate for CKD. Nephrologists should probably not ignore any longer fracture risk assessment, especially in patients with additional risk factors for osteoporosis if results will impact treatment decisions. However, although different therapeutic agents have been shown to reduce the risk of fracture in CKD patients with low BMD, specific prospective studies, with or without bone biopsies, in CKD are urgently needed.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Bover J,Bailone L,López-Báez V,Benito S,Ciceri P,Galassi A,Cozzolino Mdoi
10.1007/s40620-017-0404-zsubject
Has Abstractpub_date
2017-10-01 00:00:00pages
677-687issue
5eissn
1121-8428issn
1724-6059pii
10.1007/s40620-017-0404-zjournal_volume
30pub_type
杂志文章,评审abstract：:There is little doubt that molecular biological intervention therapy has come of age and its potential is arousing tremendous excitement. A gene transfer technique, the HVJ-liposome method, is now applicable as a tool for the dissection of molecular aspects in the pathophysiology of renal diseases, and for gene therap...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1998-01-01 00:00:00
abstract：:Chronic renal failure (CRF) is associated with a 20-fold increased risk of cardiovascular death, two principal mechanisms being: sudden, arrhythmic death associated with left ventricular hypertrophy, and ischaemic heart disease, associated with accelerated atherosclerosis. In recent years, the vascular endothelium has...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：BACKGROUND:Numerous data support the possible role of myeloblastin/proteinase 3 (PR3) in growth and differentiation of neutrophil granulocytes and certain monocyte subtypes. However, whether PR3 is expressed in non-myeloid cells remains a matter of debate even though recent studies clearly demonstrated its expression i...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2003-11-01 00:00:00
abstract：:The kidney does not usually present specific lesions in cystic fibrosis (CF), although in recent years renal involvement has been reported, particularly amyloidosis and immune complex glomerulonephritis. IgA nephropathy is rare. We report four cases of IgA nephropathy out of five renal biopsies performed in the last t...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:It has been increasingly apparent that end-stage renal disease (ESRD) patients carry an inflammatory burden, which may play a pivotal role in the evolution of not only wasting but also of the massive increase in the relative risk of cardiovascular disease (CVD). Also increased oxidative stress (an impairment of the pr...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2004-11-01 00:00:00
abstract：:The origin of the Teutonic Order of Hospitalers St. Mary (Ordo Hospitalis S. Mariae Teutonicorum Hi-erosolymitani) is presented. The St. Mary Hospitaler Teutonic Order arrived in the XIIIth century to Pomezania, then inhabited by pagan Prussian tribes. The Knights of the Order started to Christianize the Prussians, th...
journal_title：Journal of nephrology
pub_type： 历史文章,杂志文章
doi：
更新日期：2006-05-01 00:00:00
abstract：:John Allen, a British physician of the eighteenth century, deserves being remembered for a series of inventions, but most importantly -- from a 'medical' point of view -- for his highly praised manuscript, the 'Universae Medicinae Practicae,sive Doctissimorum Virorum de Morbis Eorumque Causis ac Remediis Judicia', whi...
journal_title：Journal of nephrology
pub_type： 传,历史文章,杂志文章
doi：
更新日期：2006-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.5301/jn.5000247
更新日期：2013-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/JN.2011.7740
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Reduced bone mineral density (BMD) is common in end-stage renal disease (ESRD) patients and predicts outcomes. The chronic kidney disease-mineral bone disorder contributes to low BMD in ESRD; however, the impact of classical risk factors for osteoporosis in the general population, such as body weight and fat...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/jn.5000185
更新日期：2013-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2010-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2007-01-01 00:00:00
abstract：:We report the first documented case of X-linked chronic granulomatous disease (CGD) in association with IgA nephropathy in a 22 year old male with multiple soft tissue abscesses. The case highlights the potential role of staphylococcal infections in the pathogenesis of IgA nephropathy and suggests the hypothesis that ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2002-11-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-021-00965-8
更新日期：2021-01-18 00:00:00
abstract：:A 17-year-old boy was admitted to the hospital twice in a year for 2 episodes of hemolytic uremic syndrome (HUS). During these 2 HUS episodes he had diarrhea, decreased serum complement, decreased total protein and decreased serum albumin concentrations. We suggest that protein-losing enteropathy and hypocomplementemi...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2007-03-01 00:00:00
abstract：BACKGROUND:Uremic pruritus as a symptom that affects hemodialysis (HD) patients can decrease the quality of life and increase morbidity in these patients. The aim of this study was to evaluate the effects of turmeric on uremic pruritus in HD patients. SUBJECTS AND METHODS:This was a double-blind placebo-controlled tri...
journal_title：Journal of nephrology
pub_type： 杂志文章,随机对照试验
doi：10.1007/s40620-014-0039-2
更新日期：2014-04-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2008-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-014-0107-7
更新日期：2015-02-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-015-0217-x
更新日期：2016-02-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 历史文章,杂志文章
doi：
更新日期：2006-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2005-03-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/jn.5000017
更新日期：2012-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-018-0529-8
更新日期：2018-12-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：1998-07-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 传,历史文章,杂志文章
doi：10.5301/JN.2011.6454
更新日期：2011-05-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0423-9
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-015-0243-8
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journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/jn.5000133
更新日期：2013-03-01 00:00:00
