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Longitudinal Bone Loss Occurs at the Radius in CKD

INTRODUCTION: Chronic kidney disease (CKD) exposes to an increased incidence of fragility fractures. International guidelines recommend performing bone mineral density (BMD) if the results will impact treatment decisions. It remains unknown where bone loss occurs and what would preclude the longitud...

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Autores principales: Cailleaux, Pierre-Emmanuel, Ostertag, Agnes, Metzger, Marie, Stengel, Bénédicte, Boucquemont, Julie, Houillier, Pascal, Flamant, Martin, Ureña-Torres, Pablo, Cohen-Solal, Martine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207310/
https://www.ncbi.nlm.nih.gov/pubmed/34169193
http://dx.doi.org/10.1016/j.ekir.2021.03.874
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author Cailleaux, Pierre-Emmanuel
Ostertag, Agnes
Metzger, Marie
Stengel, Bénédicte
Boucquemont, Julie
Houillier, Pascal
Flamant, Martin
Ureña-Torres, Pablo
Cohen-Solal, Martine
author_facet Cailleaux, Pierre-Emmanuel
Ostertag, Agnes
Metzger, Marie
Stengel, Bénédicte
Boucquemont, Julie
Houillier, Pascal
Flamant, Martin
Ureña-Torres, Pablo
Cohen-Solal, Martine
author_sort Cailleaux, Pierre-Emmanuel
collection PubMed
description INTRODUCTION: Chronic kidney disease (CKD) exposes to an increased incidence of fragility fractures. International guidelines recommend performing bone mineral density (BMD) if the results will impact treatment decisions. It remains unknown where bone loss occurs and what would preclude the longitudinal loss in patients with CKD. Here, we aimed to investigate factors influencing BMD and to analyze the longitudinal BMD changes. METHODS: In the NephroTest cohort, we measured BMD at the femoral neck, total hip, lumbar spine, and proximal radius, together with circulating biomarkers and standardized measured glomerular filtration rate (mGFR) by (51)Cr-EDTA in a subset of patients with CKD stage 1 to 5 followed during 4.3 ± 2.0 years. A linear mixed model explored the longitudinal bone loss and the relationship of associated factors with BMD changes. A total of 858 patients (mean age 58.9 ± 15.2 years) had at least 1 and 477 had at least 2 BMD measures. RESULTS: At baseline, cross-sectional analysis showed a significantly lower BMD at femoral neck and total hip and a significant higher serum parathyroid hormone (PTH) along with CKD stages. Baseline age, gender, tobacco, low body mass index (BMI), and high PTH levels were significantly associated with low BMD. Longitudinal analysis during the mean 4.3 years revealed a significant bone loss at the radius only. BMD changes at the femoral neck were associated with BMI, but not CKD stages or basal PTH levels. CONCLUSIONS: CKD is associated with low BMD and high PTH in the cross-sectional analysis. Longitudinal bone loss occurred at the proximal radius after 4.3 years.
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spelling pubmed-82073102021-06-23 Longitudinal Bone Loss Occurs at the Radius in CKD Cailleaux, Pierre-Emmanuel Ostertag, Agnes Metzger, Marie Stengel, Bénédicte Boucquemont, Julie Houillier, Pascal Flamant, Martin Ureña-Torres, Pablo Cohen-Solal, Martine Kidney Int Rep Clinical Research INTRODUCTION: Chronic kidney disease (CKD) exposes to an increased incidence of fragility fractures. International guidelines recommend performing bone mineral density (BMD) if the results will impact treatment decisions. It remains unknown where bone loss occurs and what would preclude the longitudinal loss in patients with CKD. Here, we aimed to investigate factors influencing BMD and to analyze the longitudinal BMD changes. METHODS: In the NephroTest cohort, we measured BMD at the femoral neck, total hip, lumbar spine, and proximal radius, together with circulating biomarkers and standardized measured glomerular filtration rate (mGFR) by (51)Cr-EDTA in a subset of patients with CKD stage 1 to 5 followed during 4.3 ± 2.0 years. A linear mixed model explored the longitudinal bone loss and the relationship of associated factors with BMD changes. A total of 858 patients (mean age 58.9 ± 15.2 years) had at least 1 and 477 had at least 2 BMD measures. RESULTS: At baseline, cross-sectional analysis showed a significantly lower BMD at femoral neck and total hip and a significant higher serum parathyroid hormone (PTH) along with CKD stages. Baseline age, gender, tobacco, low body mass index (BMI), and high PTH levels were significantly associated with low BMD. Longitudinal analysis during the mean 4.3 years revealed a significant bone loss at the radius only. BMD changes at the femoral neck were associated with BMI, but not CKD stages or basal PTH levels. CONCLUSIONS: CKD is associated with low BMD and high PTH in the cross-sectional analysis. Longitudinal bone loss occurred at the proximal radius after 4.3 years. Elsevier 2021-03-31 /pmc/articles/PMC8207310/ /pubmed/34169193 http://dx.doi.org/10.1016/j.ekir.2021.03.874 Text en © 2021 International Society of Nephrology. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research
Cailleaux, Pierre-Emmanuel
Ostertag, Agnes
Metzger, Marie
Stengel, Bénédicte
Boucquemont, Julie
Houillier, Pascal
Flamant, Martin
Ureña-Torres, Pablo
Cohen-Solal, Martine
Longitudinal Bone Loss Occurs at the Radius in CKD
title Longitudinal Bone Loss Occurs at the Radius in CKD
title_full Longitudinal Bone Loss Occurs at the Radius in CKD
title_fullStr Longitudinal Bone Loss Occurs at the Radius in CKD
title_full_unstemmed Longitudinal Bone Loss Occurs at the Radius in CKD
title_short Longitudinal Bone Loss Occurs at the Radius in CKD
title_sort longitudinal bone loss occurs at the radius in ckd
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207310/
https://www.ncbi.nlm.nih.gov/pubmed/34169193
http://dx.doi.org/10.1016/j.ekir.2021.03.874
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