The complexity of chronic kidney disease–mineral and bone disorder across stages of chronic kidney disease
| Autor: | Vanda Jorgetti, Yves Sabbagh, Fellype C. Barreto, Maria Eugênia Fernandes Canziani, Daniela V. Barreto, Luciene M. dos Reis, Katia R. Neves, Rosa M.A. Moysés, Fabiana G. Graciolli, Rosilene M. Elias, Susan C. Schiavi, Aluizio B. Carvalho |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Biopsy 030232 urology & nephrology Parathyroid hormone urologic and male genital diseases Severity of Illness Index Bone remodeling chemistry.chemical_compound 0302 clinical medicine Chronic kidney disease-mineral and bone disorder Phosphorylation beta Catenin Middle Aged Parathyroid Hormone Nephrology Bone Morphogenetic Proteins Female Bone Remodeling Adult Genetic Markers medicine.medical_specialty 030209 endocrinology & metabolism Osteocytes Bone and Bones Bone resorption 03 medical and health sciences Osteoprotegerin Renal Dialysis Internal medicine medicine Humans Renal Insufficiency Chronic Adaptor Proteins Signal Transducing Aged Receptor Parathyroid Hormone Type 1 Chronic Kidney Disease-Mineral and Bone Disorder Hyperparathyroidism business.industry medicine.disease Fibroblast Growth Factors Fibroblast Growth Factor-23 Endocrinology chemistry Case-Control Studies Sclerostin Calcium business Biomarkers Kidney disease |
| Zdroj: | Kidney International. 91:1436-1446 |
| ISSN: | 0085-2538 |
| Popis: | Chronic Kidney Disease (CKD)-Mineral and Bone Disorder (CKD-MBD) is a complex disease that is not completely understood. However, some factors secreted by the osteocytes might play an important role in its pathophysiology. Therefore, we evaluated the bone expression of proteins in a group of patients with CKD 2-3, CKD 4, and CKD 5 on dialysis and healthy individuals. We also tested several bone remodeling markers, and correlated these levels with bone biopsy findings. As expected, as serum calcium decreased, serum phosphate, alkaline phosphatase, fibroblast growth factor-23 (FGF-23), parathyroid hormone, and osteoprotegerin increased, as CKD progressed. Additionally, there was a gradual increase in bone resorption associated with a decrease in bone formation and impairment in bone mineralization. Bone expression of sclerostin and parathyroid hormone receptor-1 seemed to be increased in earlier stages of CKD, whereas FGF-23 and phosphorylated β-catenin had increased expression in the late stages of CKD, although all these proteins were elevated relative to healthy individuals. Immunohistochemical studies showed that FGF-23 and sclerostin did not co-localize, suggesting that distinct osteocytes produce these proteins. Moreover, there was a good correlation between serum levels and bone expression of FGF-23. Thus, our studies help define the complex mechanism of bone and mineral metabolism in patients with CKD. Linkage of serum markers to bone expression of specific proteins may facilitate our understanding and management of this disease. |
| Databáze: | OpenAIRE |
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