doi:10.3969/j.issn.1674-490X.2019.04.003

Abstract

Abstract: Objective Osteoporosis(OP)is one of the common complications of bone metabolic disorders in patients with chronic kidney disease(CKD), which is the most important bone metabolic disorder leading to fragile fracture in CKD patients, increasing the disability rate and mortality rate. Therefore, the pathogenesis of CKD osteoporosis is reviewed in order to provide ideas for the prevention and treatment of osteoporosis in CKD patients.

Key words: chronic kidney disease(CKD), abnormal bone metabolism, bone mineral density(BMD), osteoporosis

CLC Number:

References

[1] HOU Y C, LU C L, LU K C. Mineral bone disorders in chronic kidney disease[J]. Nephrology, 2018, 23(4): 88-94. DOI: 10.1111/nep.13457.
[2] 黄雯. 钙磷代谢及肾脏对钙磷平衡的调节[J]. 中国血液净化, 2004(4):7-9. DOI: 10.3969/j.issn.1671-4091.2004.04.001.
[3] KONG X, TANG L, MA X, et al. Relationship between mild-to-moderate chronic kidney disease and decreased bone mineral density in Chinese adult population[J]. Int Urol Nephrol, 2015, 47(9):1547. DOI: 10.1007/s11255-015-1082-1.
[4] HANUDEL M R, FROCH L, GALES B, et al. Fractures and osteomalacia in a patient treated with frequent home hemodialysis[J]. AJKD, 2017, 70(3):445-448. DOI: 10.1053/j.ajkd.2017.03.015.
[5] JAMES J. Chronic kidney disease and fragility fracture[J]. Clin Exp Nephrol, 2017, 21(Supple 1):46-52. DOI: 10.1007/s10157-016-1368-3.
[6] 洪汉利, 陈统清, 林敏娃,等. 单中心血液透析患者骨质疏松患病情况及生活质量分析[J]. 中华肾脏病杂志, 2014, 30(2):149-150. DOI: 10.3760/cma.j.issn.1001-7097.2014.02.014.
[7] YENCHEK R H, IX J H, SHLIPAK M G, et al. Bone mineral density and fracture risk in older individuals with CKD[J]. Clin J Am Soc Nephrol, 2012, 7(7):1130-1136. DOI: 10.2215/CJN.12871211.
[8] COCO M, RUSH H. Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone[J]. AJKD, 2000, 36(6):1115-1121. DOI: 10.1053/ajkd.2000.19812.
[9] FANG Y, GINSBERG C, SEIFERT M, et al. CKD-induced wingless/integration1 inhibitors and phosphorus cause the CKD-mineral and bone disorder[J]. J Am Soc Nephrol, 2014, 25: 1760-1773. DOI: 10.1681/ASN.2013080818.
[10] SLATOPOLSKY E,MOE S. 50 years of research and discovery in chronic kidney disease and mineral and bone disorder: the central role of phosphate[J]. Kidney Int, 2011, 79121: S1-S2. DOI: 10.1038/ki.2011.22.
[11] MARTIN A. Bone and heart health in chronic kidney disease: role of dentin matrix protein 1[J]. Curr Opin Nephrol Hy, 2019, 28: 297-303. DOI: 10.1097/MNH.0000000000000512.
[12] 田艳. 慢性肾脏病-矿物质和骨异常的发病机制与治疗进展[J]. 国际移植与血液净化杂志, 2015, 13(5):7-10. DOI: 10.3760/cma.j.issn.1673-4238.2015.05.003.
[13] WEBSTER A C, NAGLER E V, MORTON R L, et al. Chronic kidney disease[J]. Lancet, 2017, 389(10075):1238-1252. DOI: 10.1016/S0140-6736(16)32064-5.
[14] ZAREI A, MOROVAT A, JAVAID K, et al. Vitamin D receptor expression in human bone tissue and dose-dependent activation in resorbing osteoclasts[J]. Bone Res, 2016, 4:16030. DOI: 10.1038/boneres.2016.30.
[15] WANG Y, ZHU J, DELUCA H F. Identification of the vitamin D receptor in osteoblasts and chondrocytes but not osteoclasts in mouse bone[J]. J Bone Miner Res, 2014, 29(3):685-692. DOI: 10.1002/jbmr.2081.
[16] LANSKE B, DENSMORE M J,ERBEN R G. Vitamin D endocrine system and osteocytes[J]. Bonekey Rep, 2014, 3: 494. DOI: 10.1038/bonekey.2013.228.
[17] GARDINER E M, BALDOCK P A, THOMAS G P, et al. Increased formation and decreased resorption of bone in mice with elevated vitamin D receptor in mature cells of the osteoblastic lineage[J]. FASEB J, 2000, 14(13):1908-1916. DOI: 10.1096/fj.99-1075com.
[18] KEUNG L, PERWAD F. Vitamin D and kidney disease[J]. Bone Rep 2018, 9:93-100. DOI: 10.1016/j.bonr.2018.07.002.
[19] 陈浩, 杨帆, 贾璞, 等. 骨化三醇对骨质疏松家兔血清和骨组织维生素D水平影响的研究[J]. 临床和实验医学杂志, 2016, 15(1):1-3. DOI: 10.3969/j.issn.1671-4695.2016.01.001.
[20] HRUSKA K A, MATHEW S, LUND R, et al. Hyperphosphatemia of chronic kidney disease[J]. Kidney Int, 2008, 74(2):148-157. DOI: 10.1038/ki.2008.130.
[21] COEN G, MANTELLA D, MANNI M, et al. 25-hydroxyvitamin D levels and bone histomorphometry in hemodialysis renal osteodystrophy[J]. Kidney Int, 2005, 68(4):1840-1848. DOI: 10.1111/j.1523-1755.2005.00603.x.
[22] LEE Y H, KIM J E, ROH Y H, et al. The combination of vitamin d deficiency and mild to moderate chronic kidney disease is associated with low bone mineral density and deteriorated femoral microarchitecture: results from the KNHANES 2008–2011[J]. J Clin Eendocr Metab, 2014, 99(10):3879-3888. DOI: 10.1210/jc.2013-3764.
[23] AMBRUS C, ALMASI C, BERTA K, et al. Vitamin D insufficiency and bone fractures in patients on maintenance hemodialysis[J]. Int Urol Nephrol, 2011, 43(2):475-82. DOI: 10.1007/s11255-010-9723-x.
[24] PATRICIA P, NATALIE D, LOUIS-GEORGES S M, et al. Teriparatide and bone turnover and formation in a hemodialysis patient with low-turnover bone disease: a case report[J]. AJKD, 2015, 65(6):933-936. DOI: 10.1053/j.ajkd.2015.01.025.
[25] 张坤英,刘惠兰,段晓峰,等.血液透析患者血清骨调素和甲状旁腺素水平的相关性[J].中华肾脏病杂志,2013,29(11):812-817. DOI: 10.3760/cma.j.issn.1001-7097.2013.11.004.
[26] BYON C H, SUN Y, CHEN J, et al. Runx2-upregulated receptor activator of nuclear factor κB ligand in calcifying smooth muscle cells promotes migration and osteoclastic differentiation of macrophages[J]. Arterioscler Thromb Vasc Biol, 2011, 31(6):1387-1396. DOI: 10.1161/ATVBAHA.110.222547.
[27] SHALHOUB V, SHATZEN E M, WARD S C, et al. FGF23 neutralization improves chronic kidney disease-associated hyperparathyroidism yet increases mortality[J]. J Clin Invest, 2012, 122(7):2543-2553. DOI: 10.1172/JCI61405.
[28] MYONG J P, KIM H R, KOO J W, et al. Relationship between bone mineral density and moderate to severe chronic kidney disease among general population in korea[J]. J Korean Med Sci, 2013, 28(4):569-574. DOI: 10.3346/jkms.2013.28.4.569.
[29] OSSAREH S. Clinical and economic aspects of sevelamer therapy in end-stage renal disease patients[J]. Int J Nephrol Renovasc Dis, 2014, 7:161-168. DOI: 10.2147/IJNRD.S41626.
[30] GOETZ R, BEENKEN A, IBRAHIMI O A, et al. Molecular insights into the klotho-dependent, endocrine mode of action of fibroblast growth factor 19 subfamily members[J]. Mol Cell Biol, 2007, 27(9):3417-3428. DOI: 10.1128/MCB.02249-06.
[31] KURO-O M. Overview of the FGF23-Klotho axis[J]. Pediatr Nephrol, 2010, 25(4):583-590. DOI: 10.1007/s00467-009-1260-4.
[32] ERBEN R G,ANDRUKHOVA O. FGF23-Klotho signaling axis in the kidney[J]. Bone, 2017, 100: 62-68. DOI: 10.1016/j.bone.2016.09.010.
[33] HRUSKA K A, SUGATANI T, AGAPOVA O, et al. The chronic kidney disease-mineral bone disorder(CKD-MBD): advances in pathophysiology[J]. Bone, 2017, 100:80-86. DOI: 10.1016/j.bone.2017.01.023.
[34] CEJKA D, HERBERTH J, BRANSCUM A J, et al. Sclerostin and dickkopf-1 in renal osteodystrophy[J]. Clin J Am Soc Nephro, 2011, 6(4):877-882. DOI: 10.2215/CJN.06550810.
[35] CARRILLO-LÓPEZ N, PANIZO S, ALONSO-MONTES C, et al. Direct inhibition of osteoblastic Wnt pathway by fibroblast growth factor 23 contributes to bone loss in chronic kidney disease[J]. Kidney Int, 2016, 90(1):77-89. DOI: 10.1016/j.kint.2016.01.024.
[36] LIN W, LI Y,CHEN F, et al. Klotho preservation via histone deacetylase inhibition attenuates chronic kidney disease-associated bone injury in mice[J]. Sci Rep, 2017, 7: 46195. DOI: 10.1038/srep46195.
[37] YUAN Q, SATO M, DENSMORE H, et al. Deletion of PTH rescues skeletal abnormalities and high osteopontin levels in Klotho-/- mice[J]. PLoS Genetics, 2012, 8(5):e1002726. DOI: 10.1371/journal.pgen.1002726.
[38] KOMABA H, LANSKE B. Role of Klotho in bone and implication for CKD[J]. Curr Opin Nephrol Hypertens., 2018, 27: 298-304. DOI: 10.1097/MNH.0000000000000423.
[39] 陈雅娟,张彦定.骨形态发生蛋白的骨诱导活性及其应用研究现状[J].中国药物与临床, 2003, 3(4):277-280. DOI: 10.3969/j.issn.1671-2560.2003.04.001.
[40] SIMON M, FELIERS D, ARAR M, et al. Cloning of the 5'-flanking region of the murine bone morphogenetic protein-7 gene[J]. Mol Cell Biochem, 2002, 233(1-2):31-37. DOI: 10.1023/a:1015546615027.
[41] MANTRIPRAGADA V P,JAYASURIYA A C. Bone regeneration using injectable BMP-7 loaded chitosan microparticles in rat femoral defect[J]. Mater Sci Eng C Mater Biol Appl, 2016, 63: 596-608. DOI: 10.1016/j.msec.2016.02.080.
[42] VIANNA H R, SOARES C M, SILVEIRA K D, et al. Cytokines in chronic kidney disease: potential link of MCP-1 and dyslipidemia in glomerular diseases[J]. Pediatr Nephrol, 2013, 28(3):463-469. DOI: 10.1007/s00467-012-2363-x.
[43] PANUCCIO V, ENIA G, TRIPEPI R, et al. Pro-inflammatory cytokines and bone fractures in CKD patients. An exploratory single centre study[J]. BMC Nephrol, 2012, 13(1):134. DOI: 10.1186/1471-2369-13-134.
[44] RACHNER T D, KHOSLA S, HOFBAUER L C. Osteoporosis: now and the future[J]. Lancet, 2011, 377(9773):1276-1287. DOI: 10.1016/S0140-6736(10)62349-5.
[45] RAGAB A A, NALEPKA J L, BI Y, et al. Cytokines synergistically induce osteoclast differentiation: Support by immortalized or normal calvarial cells[J]. Am J Physiol-Cell Ph, 2002, 283(3):C679-C687. DOI: 10.1152/ajpcell.00421.2001.
[46] LAM J, TAKESHITA S, BARKER J E, et al. TNF-alpha induces osteoclastogenesis by direct stimulation of macrophages exposed to permissive levels of RANK ligand[J]. J Clin Invest, 2000, 106(12):1481-1488. DOI: 10.1172/JCI11176.
[47] LI Y, LI A, STRAIT K, et al. Endogenous TNFalpha lowers maximum peak bone mass and inhibits osteoblastic Smad activation through NF-kappaB[J]. J Bone Miner Res, 2007, 22(5):646-655. DOI: 10.1359/jbmr.070121.
[48] DINARELLO C A. The interleukin-1 family: 10 years of discovery[J]. Faseb J, 1994, 8(15):1314-1325. DOI: 10.1096/fasebj.8.15.8001745.
[49] KOTAKE S,SATO K, KIM K J, et al. Interleukin-6 and soluble interleukin-6 receptors in the synovial fluids from rheumatoid arthritis patients are responsible for osteoclast-like cell formation[J]. J Bone Miner Res, 1996, 11: 88-95. DOI: 10.1002/jbmr.5650110113.
[50] KWAN T S,PADRINES M, THÉOLEYRE S, et al. IL-6, RANKL, TNF-alpha/IL-1: interrelations in bone resorption pathophysiology[J]. Cytokine Growth Factor Rev, 2004, 15:49-60. DOI: 10.1016/j.cytogfr.2003.10.005.
[51] ROMAS E, GILLESPIE M T, MARTIN T J. Involvement of receptor activator of NFκB ligand and tumor necrosis factor-α in bone destruction in rheumatoid arthritis[J]. Bone, 2002, 30(2):340-346. DOI: 10.1016/s8756-3282(01)00682-2.
[52] BOYCE B F, XING L. The RANKL/RANK/OPG pathway[J]. Curr Osteoporos Rep, 2007, 5(3):98-104. DOI: 10.1007/s11914-007-0024-y.
[53] BOYCE B F, XING L. Functions of RANKL/RANK/OPG in bone modeling and remodeling[J]. Arch Biochem Biophys, 2008, 473(2):139-146. DOI: 10.1016/j.abb.2008.03.018.
[54] SECK T, DIEL I, BISMAR H, et al. Serum parathyroid hormone, but not menopausal status, is associated with the expression of osteoprotegerin and RANKL mRNA in human bone samples[J]. Eur J Endocrinol, 2001, 145(2):199-205. DOI: 10.1530/eje.0.1450199.
[55] FAHRLEITNER-PAMMER A, DOBNIG H, DIMAI H P, et al. The effect of RANKL and OPG on bone mineral density in pre-dialysis chronic renal failure[J]. Clin Nephrol, 2009, 71(6):652-659. DOI: 10.5414/CNP71652.
[56] BARON R, KNEISSEL M. WNT signaling in bone homeostasis and disease: from human mutations to treatments[J]. Nat Med, 2013, 19(2):179-192. DOI: 10.1038/nm.3074.
[57] TU X, DELGADO-CALLE J, CONDON K W, et al. Osteocytes mediate the anabolic actions of canonical Wnt/β-catenin signaling in bone[J]. Proc Natl Acad Sci USA, 2015, 112(5):E478-E486. DOI: 10.1073/pnas.1409857112.
[58] SABBAGH Y, GRACIOLLI F G, O'BRIEN S, et al. Repression of osteocyte Wnt/β-catenin signaling is an early event in the progression of renal osteodystrophy[J]. J Bone Miner Res, 2012, 27(8): 1757-1772.10. DOI: 10.1002/jbmr.1630.
[59] DELANAYE P, CAVALIER E, BOUQUEGNEAU A, et al. Sclerostin levels in CKD patients: an important, but not definitive, step on the way to clinical use[J]. Kidney Int, 2015, 88(6):1221-1223. DOI: 10.1038/ki.2015.258.
[60] PELLETIER S, DUBOURG L, CARLIER M C, et al. The relation between renal function and serum sclerostin in adult patients with CKD[J]. Clin J Am Soc Nephrol, 2013, 8(5):819-823. DOI: 10.2215/CJN.07670712.

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 3

Recommended Articles

Metrics

Comments

[1]	ZHANG Yin'en, JIAO Jianbao. Developments on Kümmell's disease [J]. Journal of Hebei Medical College for Continuing Education, 2022, 39(3): 47-53.
[2]	. [J]. Journal of Hebei Medical College for Continuing Education, 2021, 38(6): 36-43.
[3]	DUAN Fei,HAO Huachao,XUE Juan,LI Shaochun,LIU Weihua,GU Yu,SUN Xiaofang. Effects ofα-zeranol on the IL-6 expression and secretion in rat osteoblasts [J]. Medical Reserch and Education, 2014, 31(1): 1-7.