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Chronic kidney disease and bone metabolism

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Abstract

Chronic kidney disease-related mineral and bone disease (CKD-MBD) is a syndrome defined as a systemic mineral metabolic disorder associated with CKD, and the term renal osteodystrophy indicates a pathomorphological concept of bone lesions associated with CKD-MBD. Cortical bone thinning, abnormalities in bone turnover and primary/secondary mineralization, elevated levels of circulating sclerostin, increased apoptosis in osteoblasts and osteocytes, disturbance of the coupling phenomenon, iatrogenic factors, accumulated micro-crackles, crystal/collagen disorientation, and chemical modification of collagen crosslinks are all possible candidates found in CKD that could promote osteopenia and/or bone fragility. Some of above factors are the consequences of abnormal systemic mineral metabolism but for others it seem unlikely. We have used the term uremic osteoporosis to describe the uremia-induced bone fragility which is not derived from abnormal systemic mineral metabolism. Interestingly, the disease aspect of uremic osteoporosis appears to be similar to that of senile osteoporosis.

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Authors and Affiliations

  1. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Junichiro James Kazama & Koji Matsuo

  2. Department of Health Sciences, Oita University of Nursing and Health Sciences, Oita, Japan

    Yoshiko Iwasaki

  3. Division of Nephrology and Metabolism, Tokai University School of Medicine, Isehara, Japan

    Masafumi Fukagawa

  4. Division of Blood Purification Therapy, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-Ku Niigata, Niigata, 951-8510, Japan

    Junichiro James Kazama

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  1. Junichiro James Kazama
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  2. Koji Matsuo
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  4. Masafumi Fukagawa
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Correspondence to Junichiro James Kazama.

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Kazama, J.J., Matsuo, K., Iwasaki, Y. et al. Chronic kidney disease and bone metabolism. J Bone Miner Metab 33, 245–252 (2015). https://doi.org/10.1007/s00774-014-0639-x

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