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Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy
Chronic kidney disease–mineral and bone disorder (CKD-MBD) is the term used to describe a constellation of biochemical abnormalities, bone disturbances that may lead to fractures, and extraskeletal calcification in soft tissues and arteries seen in CKD. This review focuses on the non-invasive diagno...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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2013
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805700/ https://www.ncbi.nlm.nih.gov/pubmed/23802194 http://dx.doi.org/10.1038/ki.2013.254 |
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author | Moorthi, Ranjani N Moe, Sharon M |
author_facet | Moorthi, Ranjani N Moe, Sharon M |
author_sort | Moorthi, Ranjani N |
collection | PubMed |
description | Chronic kidney disease–mineral and bone disorder (CKD-MBD) is the term used to describe a constellation of biochemical abnormalities, bone disturbances that may lead to fractures, and extraskeletal calcification in soft tissues and arteries seen in CKD. This review focuses on the non-invasive diagnosis of renal osteodystrophy, the term used exclusively to define the bone pathology associated with CKD. Transiliac bone biopsy and histomorphometry with double-labeled tetracycline or its derivatives remains the gold standard for diagnosis of renal osteodystrophy. However, histomorphometry provides a “window” into bone only at a single point in time, is invasive, and not practical to study continuous changes in bone morphology. Further, CKD is a risk factor for fractures, and the etiology is multi-factorial and not fully explained by histomorphometry findings alone. The propensity of a bone to fracture is determined by bone strength, which is affected by bone mass and bone quality; the latter is a term used to describe the structure and composition of bone. Bone quantity is traditionally assessed by Dual X-ray Absorptiometry (DXA) and CT based methods. Bone quality is more difficult to assess non- invasively, but newer techniques are emerging and described in this review. Ultimately, the optimal diagnostic strategy for renal osteodystrophy may be a combination of multiple imaging techniques and biomarkers that are specific to each gender and race in CKD with a goal of predicting fracture risk and optimizing therapy. |
format | Online Article Text |
id | pubmed-3805700 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
record_format | MEDLINE/PubMed |
spelling | pubmed-38057002014-05-01 Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy Moorthi, Ranjani N Moe, Sharon M Kidney Int Article Chronic kidney disease–mineral and bone disorder (CKD-MBD) is the term used to describe a constellation of biochemical abnormalities, bone disturbances that may lead to fractures, and extraskeletal calcification in soft tissues and arteries seen in CKD. This review focuses on the non-invasive diagnosis of renal osteodystrophy, the term used exclusively to define the bone pathology associated with CKD. Transiliac bone biopsy and histomorphometry with double-labeled tetracycline or its derivatives remains the gold standard for diagnosis of renal osteodystrophy. However, histomorphometry provides a “window” into bone only at a single point in time, is invasive, and not practical to study continuous changes in bone morphology. Further, CKD is a risk factor for fractures, and the etiology is multi-factorial and not fully explained by histomorphometry findings alone. The propensity of a bone to fracture is determined by bone strength, which is affected by bone mass and bone quality; the latter is a term used to describe the structure and composition of bone. Bone quantity is traditionally assessed by Dual X-ray Absorptiometry (DXA) and CT based methods. Bone quality is more difficult to assess non- invasively, but newer techniques are emerging and described in this review. Ultimately, the optimal diagnostic strategy for renal osteodystrophy may be a combination of multiple imaging techniques and biomarkers that are specific to each gender and race in CKD with a goal of predicting fracture risk and optimizing therapy. 2013-06-26 2013-11 /pmc/articles/PMC3805700/ /pubmed/23802194 http://dx.doi.org/10.1038/ki.2013.254 Text en http://www.nature.com/authors/editorial_policies/license.html#terms Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Moorthi, Ranjani N Moe, Sharon M Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy |
title | Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy |
title_full | Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy |
title_fullStr | Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy |
title_full_unstemmed | Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy |
title_short | Recent Advances in the Non-invasive Diagnosis of Renal Osteodystrophy |
title_sort | recent advances in the non-invasive diagnosis of renal osteodystrophy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805700/ https://www.ncbi.nlm.nih.gov/pubmed/23802194 http://dx.doi.org/10.1038/ki.2013.254 |
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