Recent advances in the noninvasive diagnosis of renal osteodystrophy

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

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 noninvasive 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, and is not clinically practical for studying continuous changes in bone morphology. Furthermore, the etiology of fractures in CKD is multifactorial 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 noninvasively, but newer techniques are emerging and are 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.

Original languageEnglish
Pages (from-to)886-894
Number of pages9
JournalKidney International
Volume84
Issue number5
DOIs
StatePublished - Nov 2013

Fingerprint

Chronic Kidney Disease-Mineral and Bone Disorder
Bone and Bones
Bone Fractures
Photon Absorptiometry
Tetracycline
Arteries
Biomarkers
Pathology

Keywords

  • bone biomarker
  • bone quality
  • CKD-MBD
  • dual X-ray absorptiometry
  • parathyroid hormone
  • renal osteodystrophy

ASJC Scopus subject areas

  • Nephrology

Cite this

Recent advances in the noninvasive diagnosis of renal osteodystrophy. / Moorthi, Ranjani; Moe, Sharon.

In: Kidney International, Vol. 84, No. 5, 11.2013, p. 886-894.

Research output: Contribution to journalArticle

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