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Parathyroid suppression therapy normalizes chronic kidney disease-induced elevations in cortical bone vascular perfusion: a pilot study

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Abstract

Summary

Interventions that alter PTH levels in an animal model of chronic kidney disease have effects on the perfusion of bone and bone marrow.

Introduction

Patients with chronic kidney disease (CKD) have accelerated bone loss, vascular calcification, and abnormal biochemistries, together contributing to an increased risk of cardiovascular disease and fracture-associated mortality. Despite evidence of vascular pathologies and dysfunction in CKD, our group has shown that cortical bone tissue perfusion is higher in a rat model of high-turnover CKD. The goal of the present study was to test the hypothesis that parathyroid hormone (PTH) suppressive interventions would normalize cortical bone vascular perfusion in the setting of CKD.

Methods

In two separate experiments, 35-week-old CKD animals and their normal littermates underwent intra-cardiac fluorescent microsphere injection to assess the effect of 10 weeks of PTH suppression (Experiment 1: calcium supplementation, Experiment 2: calcimimetic treatment) on alterations in bone tissue perfusion.

Results

In Experiment 1, CKD animals had serum blood urea nitrogen (BUN) and PTH levels significantly higher than NL (+ 182% and + 958%; p < 0.05). CKD+Ca animals had BUN levels that were similar to CKD, while PTH levels were significantly lower and comparable to NL. Both femoral cortex (+ 220%, p = 0.003) and tibial cortex (+ 336, p = 0.005) tissue perfusion were significantly higher in CKD animals when compared to NL; perfusion was normalized to those of NL in CKD+Ca animals. MicroCT analysis of the proximal tibia cortical porosity showed a trend toward higher values in CKD (+ 401%; p = 0.017) but not CKD+Ca (+ 111%; p = 0.38) compared to NL. Experiment 2, using an alternative method of PTH suppression, showed similar results as those of Experiment 1.

Conclusions

These data demonstrate that PTH suppression-based interventions normalize cortical bone perfusion in the setting of CKD.

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Acknowledgements

This work was supported by a United States (U.S.) Department of Veterans Affairs grant (BX003025) to MRA. MWA was supported by F30 DK115162 and T32 AR065971 during separate portions of this work. KP-2326 was provided through a material transfer agreement with Amgen.

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Authors and Affiliations

  1. Department of Anatomy and Cell Biology, MS 5035, Indiana University School of Medicine, 635 Barnhill Dr, Indianapolis, IN, 46202, USA

    M.W. Aref, E.A. Swallow, C.E. Metzger & M.R. Allen

  2. Department of Medicine – Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA

    N. Chen, S.M. Moe & M.R. Allen

  3. Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA

    S.M. Moe & M.R. Allen

  4. Department of Biomedical Engineering, Indiana University Purdue University of Indianapolis, Indianapolis, IN, USA

    M.R. Allen

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  1. M.W. Aref
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  2. E.A. Swallow
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  3. C.E. Metzger
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  4. N. Chen
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  5. S.M. Moe
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  6. M.R. Allen
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Correspondence to M.R. Allen.

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Aref, M., Swallow, E., Metzger, C. et al. Parathyroid suppression therapy normalizes chronic kidney disease-induced elevations in cortical bone vascular perfusion: a pilot study. Osteoporos Int 30, 1693–1698 (2019). https://doi.org/10.1007/s00198-019-04974-z

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  • DOI: https://doi.org/10.1007/s00198-019-04974-z

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