Skip to main content
SpringerLink
Log in

Renal Diseases and Skeletal Health

  • Chapter
  • First Online:
Multidisciplinary Approach to Osteoporosis

  • 666 Accesses

Abstract

Recent clinical observations underline the link between bone disease and disturbances of mineral metabolism with increased morbidity and mortality of Chronic Renal Failure (CRF). Indeed, in patients with Chronic Kidney Disease (CKD), bone disease may occur either with normal glomerular filtration rate (renal tubular disorders involving pH, Calcium or Phosphate metabolism) or with reduced glomerular filtration rate (the complex endocrine disorder of secondary hyperparathyroidism of CRF). Recently, to underline the clinical burden of this type of secondary hyperparathyroidism, a new clinical term has been introduced: CKD-MBD (chronic kidney disease-mineral and bone disorder). Besides bone disease, the endocrine derangements of mineral metabolism and the accelerated calcification processes of vessel walls are considered together in this syndrome, to highlight the pathogenetic link with cardiovascular disease and the eventual morbidity and mortality. The gold standard technique to diagnose renal osteodystrophy still remains the invasive bone biopsy. The less invasive biomarkers and radiologic techniques are less reliable to evaluate bone histology but are necessary to study the hormonal condition and the mechanical performance of the skeleton, respectively. As for therapy, it has been mostly focused on the control of secondary hyperparathyroidism, but this does not impact significantly the high fracture rate of renal patients. New drugs employed for osteoporosis and targeting specific functions of bone cells promise to open new therapeutic frontiers for renal osteodystrophy and CKD-MBD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Levey AS, de Jong PE, Coresh J, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011;80:17–28.

    Article  PubMed  Google Scholar 

  2. Mazzaferro S, Pasquali M, Pirrò G, Rotondi S, Tartaglione L. The bone and the kidney. Arch Biochem Biophys. 2010;503:95–102.

    Article  CAS  PubMed  Google Scholar 

  3. Heilberg IP, Weisinger JR. Bone disease in idiopathic hypercalciuria. Curr Opin Nephrol Hypertens. 2006;15:394–402.

    Article  CAS  PubMed  Google Scholar 

  4. Vezzoli G, Soldato L, Gambaro G. Hypercalciuria revisited: one or many conditions? Pediatr Nephrol. 2008;23:503–606.

    Article  PubMed  Google Scholar 

  5. Thakker RV. Pathogenesis of Dent’s disease and related syndromes of X-linked nephrolithiasis. Kidney Int. 2000;57:787–93.

    Article  CAS  PubMed  Google Scholar 

  6. Devuyst O, Pirson Y. Genetics of hypercalciuric stone forming disease. Kidney Int. 2007;72:1065–72.

    Article  CAS  PubMed  Google Scholar 

  7. Bergwitz C, Roslin NM, Tieder M, et al. SCL34A3 mutations in patient with hereditary hypophosphatemic rickets with hypercalciuria predict key role for the sodium-phosphate cotransporter NaPi-IIc in maintaining phosphate homeostasis. Am J Hum Genet. 2006;78:179–92.

    Article  CAS  PubMed  Google Scholar 

  8. Bushinsky DA, Goldring JM, Coe FL. Cellular contribution to pH-mediated calcium flux in neonatal mouse calvariae. Am J Physiol. 1985;248:F785–9.

    PubMed  CAS  Google Scholar 

  9. Krieger NS, Parker WR, Alexander KM, Bushinsky DA. Prostaglandins regulate acid-induced cell-mediated bone resorption. Am J Physiol Renal Physiol. 2000;279:F1077–82.

    Article  CAS  PubMed  Google Scholar 

  10. Frick KK, Bushinsky DA. Metabolic acidosis stimulates RANKL RNA expression in bone through a cyclo-oxygenase-dependent mechanism. J Bone Miner Res. 2003;18:1317–25.

    Article  CAS  PubMed  Google Scholar 

  11. Bushinsky DA. Stimulated osteoclastic and suppressed osteoblastic activity in metabolic but not respiratory acidosis. Am J Physiol. 1995;268:C80–8.

    Article  CAS  PubMed  Google Scholar 

  12. Nijenhuis T, Renkema KY, Hoenderop JG, Bindels RY. Acid-base status determines the renal expression of Ca2+ and Mg2+ transport proteins. J Am Soc Nephrol. 2006;17:617–26.

    Article  CAS  PubMed  Google Scholar 

  13. Ludwig MG, Vanek M, Guerini D, et al. Proton sensing G-protein–coupled receptors. Nature. 2003;425:93–8.

    Article  CAS  PubMed  Google Scholar 

  14. Jahr H, van Driel M, van Osch GJ, Weinans H, van Leeuwen JP. Identification of acid-sensing ion channels in bone. Biochem Biophys Res Commun. 2005;337:349–54.

    Article  CAS  PubMed  Google Scholar 

  15. Clarke BL, Wynne AG, Wilson DM, Fitzpatrick LA. Osteomalacia associated with adult Fanconi’s syndrome: clinical and diagnostic features. Clin Endocrinol. 1995;43:479–90.

    Article  CAS  Google Scholar 

  16. Shimada T, Urakawa I, Yamazaki Y, et al. FGF-23 transgenic mice demonstrate hypophosphatemic rickets with reduced expression of sodium phosphate cotransporter type IIa. Biochem Biophys Res Commun. 2004;312:409–14.

    Article  CAS  Google Scholar 

  17. Slatopolsky E, Caglar S, Pennell JP, et al. On the pathogenesis of hyperparathyroidism in chronic experimental renal insufficiency in the dog. J Clin Invest. 1971;50:492–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Slatopolsky E, Finch J, Denda M, et al. Phosphorus restriction prevents parathyroid gland growth. High phosphorus directly stimulates PTH secretion in vitro. J Clin Invest. 1996;97:2534–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Mian IS. Sequence, structural, functional, and phylogenetic analyses of three glycosidase families. Blood Cells Mol Dis. 1998;2:83–100.

    Google Scholar 

  20. Rotondi S, Pasquali M, Tartaglione L, et al. Soluble α-Klotho serum levels in chronic kidney disease. Int J Endocrinol. 2015;2015:1–8.

    Article  CAS  Google Scholar 

  21. Yu J, Deng M, Zhao J, Huang L. Decreased expression of klotho gene in uremic atherosclerosis in apolipoprotein E deficient mice. Biochem Biophys Res Comm. 2010;391:261–6.

    Article  CAS  PubMed  Google Scholar 

  22. Levin A, Bakris GL, Molitch M, et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int. 2007;71:31–8.

    Article  CAS  PubMed  Google Scholar 

  23. Shimada T, Hasegawa H, Yamazaki Y, et al. FGF23 is a potent regulator of vitamin D metabolism and phosphate homeostasis. J Bone Miner Res. 2004;19:429–35.

    Article  CAS  PubMed  Google Scholar 

  24. Silver J, Naveh-Many T. FGF23 and the parathyroid glands. Pediatr Nephrol. 2010;25:2241–5.

    Article  PubMed  Google Scholar 

  25. Canaff L, Hendy GN. Human calcium-sensing receptor gene. Vitamin D response elements in promoters P1 and P2 confer transcriptional responsiveness to 1,25-dihydroxyvitamin D. J Biol Chem. 2002;277:30337–50.

    Article  CAS  PubMed  Google Scholar 

  26. Tfelt-Hansen J, Brown EM. The calcium-sensing receptor in normal physiology and pathophysiology: a review. Crit Rev Clin Lab Sci. 2005;42:35–70.

    Article  CAS  PubMed  Google Scholar 

  27. Dusso A, Arcidiacono MV, Yang J, Tokumoto M. Vitamin D inhibition of TACE and prevention of renal osteodystrophy and cardiovascular mortality. J Steroid Biochem Mol Biol. 2010;121:193–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Silverberg SJ, Shane E, de la Cruz L, et al. Skeletal disease in primary hyperparathyroidism. J Bone Miner Res. 1989;4:283–91.

    Article  CAS  PubMed  Google Scholar 

  29. Rodda SJ, McMahon AP. Distinct role for Hedgehog and canonical Wnt signaling in specification, differentiation and maintenance of osteoblast progenitors. Development. 2006;133:3231–44.

    Article  CAS  PubMed  Google Scholar 

  30. Fang Y, Ginsberg C, Seifert M, et al. CKD-induced wingless/integration1 inhibitors and phosphorus cause the CKD-mineral and bone disorder. J Am Soc Nephrol. 2014;25:1760–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Pelletier S, Dubourg L, Carlier MC, Hadj-Aissa A, Fouque D. The relation between renal function and serum sclerostin in adult patients with CKD. Clin J Am Soc Nephrol. 2013;8:819–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Sabbagh Y, Graciolli FG, O’Brien S, et al. Repression of osteocyte Wnt/beta-catenin signaling is an early event in the progression of renal osteodystrophy. J Bone Miner Res. 2012;27:1757–72.

    Article  CAS  PubMed  Google Scholar 

  33. Graciolli FG, Naves KR, Barreto F, et al. The complexity of chronic kidney disease-mineral bone disorder across stages of chronic kidney disease. Kidney Int. 2017;91:1436–46.

    Article  CAS  PubMed  Google Scholar 

  34. Cejka D, Herberth J, Branscum AJ, et al. Sclerostin and dickkopf-1 in renal osteodystrophy. Clin J Am Soc Nephrol. 2011;6:877–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Drueke TB, Massy ZA. Changing bone patterns with progression of chronic kidney disease. Kidney Int. 2016;89:289–302.

    Article  PubMed  Google Scholar 

  36. Pereira RC, Valta H, Tumber N, et al. Altered osteocyte-specific protein expression in bone after childhood solid organ transplantation. PLoS One. 2015;10:1–12.

    Google Scholar 

  37. Martin A, David V, Li H, et al. Overexpression of the DMP1 C-terminal fragment stimulates FGF23 and exacerbates the hypophosphatemic rickets phenotype in Hyp mice. Mol Endocrinol. 2012;26:1883–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Gomez F, de la Cueva R, Wauters JP, Lemarchand-Beraud T. Endocrine abnormalities in patients undergoing longterm hemodialysis: the role of prolactin. Am J Med. 1980;68:522–30.

    Article  CAS  PubMed  Google Scholar 

  39. Handelsman DJ, Dong Q. Hypothalamo-pituitary gonadal axis in chronic renal failure. Endocrinol Metab Clin North Am. 1993;22:145–61.

    Article  CAS  PubMed  Google Scholar 

  40. Kousteni S, Bellido T, Plotkin LI, et al. Non genotropic, sex-non specific signaling through the estrogen or androgen receptors: dissociation from transcriptional activity. Cell. 2001;104:719–30.

    PubMed  CAS  Google Scholar 

  41. Pederson L, Kremer M, Judd J, et al. Androgens regulate bone resorption activity of isolated osteoclasts in vitro. Proc Natl Acad Sci U S A. 1999;96:505–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Niwa T, Takeda N, Tatematsu A, et al. Accumulation of indoxyl sulfate, an inhibitor of drug-binding, in uremic serum as demonstrated by internal-surface reversed-phase liquid chromatography. Clin Chem. 1988;34:2264–7.

    PubMed  CAS  Google Scholar 

  43. Nii-Kono T, Iwasaki Y, Uchida M, et al. Indoxyl sulfate induces skeletal resistance to parathyroid hormone in cultured osteoblastic cells. Kidney Int. 2007;71:738–43.

    Article  CAS  PubMed  Google Scholar 

  44. Mozar A, Louvet L, Godin C, et al. Indoxyl sulphate inhibits osteoclast differentiation and function. Nephrol Dial Transplant. 2012;27:2176–81.

    Article  CAS  PubMed  Google Scholar 

  45. Iwasaki Y, Yamato H, Nii-Kono T, et al. Administration of oral charcoal adsorbent (AST-120) suppresses low-turnover bone progression in uraemic rats. Nephrol Dial Transplant. 2006;21:2768–74.

    Article  CAS  PubMed  Google Scholar 

  46. Moe S, Drüeke T, Block GA, et al. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. 2009;76:S3–S130.

    Google Scholar 

  47. Moe S, Drüeke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69:1945–53.

    Article  CAS  PubMed  Google Scholar 

  48. Mazzaferro S, Tartaglione L, Rotondi S, Bover J, Goldsmith D, Pasquali M. News on biomarkers in CKD-MBD. Semin Nephrol. 2014;34:598–611.

    Article  CAS  PubMed  Google Scholar 

  49. Garrett G, Sardiwal S, Lamb EJ, Goldsmith DJ. PTH--a particularly tricky hormone: why measure it at all in kidney patients? Clin J Am Soc Nephrol. 2013;8:299–312.

    Article  CAS  PubMed  Google Scholar 

  50. Ureña P, Hruby M, Ferreira A, Ang KS, de Vernejoul MC. Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. J Am Soc Nephrol. 1996;7:506–12.

    PubMed  Google Scholar 

  51. Drechsler C, Verduijn M, Pilz S, Krediet RT, et al. Bone alkaline phosphatase and mortality in dialysis patients. Clin J Am Soc Nephrol. 2011;6:1752–9.

    Article  CAS  PubMed  Google Scholar 

  52. Yamada S, Inaba M, Kurajoh M, Shidara K, Imanishi Y, Ishimura E, et al. Utility of serum tartrate-resistant acid phosphatase (TRAP5b) as a bone resorption marker inpatients with chronic kidney disease: independence from renal dysfunction. Clin Endocrinol. 2008;69:189–96.

    Article  CAS  Google Scholar 

  53. Henriksen K, Tanko LB, Qvist P, Delmas PD, Christiansen C, Karsdal MA. Assessment of osteoclast number and function: application in the development of new and improved treatment modalities for bone diseases. Osteoporos Int. 2007;18(5):681.

    Article  CAS  PubMed  Google Scholar 

  54. Coen G, Mazzaferro S, Bonucci E, Taggi F, Ballanti P, Bianchi AR, et al. Bone GLA protein in predialysis chronic renal failure. Effects of 1,25(OH)2D3 administration in a long term follow-up. Kidney Int. 1985;28:783–90.

    Article  CAS  PubMed  Google Scholar 

  55. Vasikaran S, Eastell R, Bruyere O, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011;22:391–420.

    Article  CAS  PubMed  Google Scholar 

  56. Johnell O, Oden A, De Laet C, et al. Biochemical indices of bone turnover and the assessment of fracture probability. Osteoporos Int. 2002;13:523–6.

    Article  CAS  PubMed  Google Scholar 

  57. Grabner A, Mazzaferro S, Cianciolo G, et al. Fibroblast growth factor 23: mineral metabolism and beyond. Contrib Nephrol. 2017;190:83–95.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Marçais C, Maucort-Boulch D, Drai J, et al. Circulating Klotho associates with cardiovascular morbidity and mortality during hemodialysis. J Clin Endocrinol Metab. 2017;102(9):3154–61. [Epub ahead of print].

    Article  PubMed  Google Scholar 

  59. Evenepoel P, D’Haese P, Bacchetta J, et al. Bone biopsy practice patterns across Europe: the European renal osteodystrophy initiative-a position paper. Nephrol Dial Transplant. 2017;32(10):1608–13. [Epub ahead of print].

    PubMed  Google Scholar 

  60. Torres PU, Bover J, Mazzaferro S. When, how, and why a bone biopsy should be performed in patients with chronic kidney disease. Semin Nephrol. 2014;34:612–25.

    Article  PubMed  Google Scholar 

  61. Alem AM, Sherrard DJ, Gillen DL, et al. Increased risk of hip fracture among patients with end-stage renal disease. Kidney Int. 2000;58:396–9.

    Article  CAS  PubMed  Google Scholar 

  62. Wakasugi M, Kazama JJ, Taniguchi M, et al. Increased risk of hip fracture among Japanese hemodialysis patients. J Bone Miner Metab. 2013;31:315–21.

    Article  PubMed  Google Scholar 

  63. Yenchek RH, Ix JH, Shlipak MG, Bauer DC, Rianon NJ, Kritchevsky SB, Harris TB, Newman AB, Cauley JA, Fried LF, Health, Aging, and Body Composition Study. Bone mineral density and fracture risk in older individuals with CKD. Clin J Am Soc Nephrol. 2012;7:1130–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Jamal SA, West SL, Miller PD. Fracture risk assessment in patients with chronic kidney disease. Osteoporos Int. 2012;23:1191–8.

    Article  CAS  PubMed  Google Scholar 

  65. Jamal SA, West SL, Miller PD. Bone and kidney disease: diagnostic and therapeutic implications. Curr Rheumatol Rep. 2012;14:217–23.

    Article  CAS  PubMed  Google Scholar 

  66. Ott SM. When bone mass fails to predict bone failure. Calcif Tissue Int. 1993;53(Suppl. 1):S7–13.

    Article  PubMed  Google Scholar 

  67. Jamal SA, Hayden JA, Beyene J. Low bone mineral density and fractures in long term hemodialysis patients: a meta-analysis. Am J Kidney Dis. 2007;49:674–81.

    Article  PubMed  Google Scholar 

  68. Jamal SA, Cheung AM, West S, Lok C. Bone mineral density by DXA and HR pQCT can discriminate fracture status in men and women with stages 3 to 5 chronic kidney disease. Osteoporos Int. 2012;23:2805–13.

    Article  CAS  PubMed  Google Scholar 

  69. Nishiyama KK, Macdonald HM, Buie HR, Hanley DA, Boyd SK. Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: an in vivo HR-pQCT study. J Bone Miner Res. 2010;25:882–90.

    PubMed  Google Scholar 

  70. Liu XS, Stein EM, Zhou B, et al. Individual trabecula segmentation (ITS)-based morphological analyses and microfinite element analysis of HRpQCT images discriminate postmenopausal fragility fractures independent of DXA measurements. J Bone Miner Res. 2012;27:263–72.

    Article  PubMed  Google Scholar 

  71. Pereira RC, Bischoff DS, Yamaguchi D, Salusky IB, Wesseling-Perry K. Micro-CT in the assessment of pediatric renal osteodystrophy by bone histomorphometry. Clin J Am Soc Nephrol. 2016;11:481–7.

    Article  CAS  PubMed  Google Scholar 

  72. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2010;285:785–95.

    Article  Google Scholar 

  73. Kanis JA, on behalf of the World Health Organization Scientific Group. Assessment of osteoporosis at the primary health-care level. Technical report. Sheffield: World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield; 2007. Printed by the University of Sheffield.

    Google Scholar 

  74. Tartaglione L, Pasquali M, Rotondi S, Muci ML, Covic A, Mazzaferro S. Positioning novel biologicals in CKD mineral and bone disorders. J Nephrol. 2017;30(5):689–99. [Epub ahead of print].

    Article  CAS  PubMed  Google Scholar 

  75. Miller PD. Diagnosis and treatment of osteoporosis in chronic renal disease. Semin Nephrol. 2009;29:144–55.

    Article  CAS  PubMed  Google Scholar 

  76. Lane NE, Parimi N, Corr M, et al. Association of serum fibroblast growth factor 23 (FGF23) and incident fractures in older men: the Osteoporotic Fractures in Men (MrOS) study. J Bone Miner Res. 2013;28:2325–32.

    Article  CAS  PubMed  Google Scholar 

  77. Jamal SA, West SL, Nickolas TL. The clinical utility of FRAX to discriminate fracture status in men and women with chronic kidney disease. Osteoporos Int. 2014;25(1):71–6.

    Article  CAS  PubMed  Google Scholar 

  78. Naylor KL, Leslie WD, Hodsman AB, Rush DN, Garg AX. FRAX predicts fracture risk in kidney transplant recipients. Transplantation. 2014;97:940–5.

    Article  CAS  PubMed  Google Scholar 

  79. West SL, Lok CE, Langsetmo L, Cheung AM, Szabo E, Pearce D, et al. Bone mineral density predicts fractures in chronic kidney disease. J Bone Miner Res. 2015;30:913–919 8.

    Article  PubMed  Google Scholar 

  80. Nickolas TL, Cremers S, Zhang A, et al. Discriminants of prevalent fractures in chronic kidney disease. J Am Soc Nephrol. 2011;22:1560–72.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Naylor KL, Garg AX, Zou G, et al. Comparison of fracture risk prediction among individuals with reduced and normal kidney function. Clin J Am Soc Nephrol. 2015;10:646–53.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Fried LF, Biggs ML, Shlipak MG, et al. Association of kidney function with incident hip fracture in older adults. J Am Soc Nephrol. 2007;18:282–6.

    Article  PubMed  Google Scholar 

  83. Coco M, Rush H. Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone. Am J Kidney Dis. 2000;36:1115–21.

    Article  CAS  PubMed  Google Scholar 

  84. Beaubrun AC, Kilpatrick RD, Freburger JK, Bradbury BD, Wang L, Brookhart MA. Temporal trends in fracture rates and postdischarge outcomes among hemodialysis patients. J Am Soc Nephrol. 2013;24(9):1461.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Naylor K, McArthur E, Leslie W, et al. Three three-year incidence of fracture in chronic kidney disease. Kidney Int. 2014;86:810–8.

    Article  PubMed  Google Scholar 

  86. Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what’s changed and why it matters. Kidney Int. 2017;92:23–36.

    Article  Google Scholar 

  87. Moe SM. Renal osteodystrophy or kidney-induced osteoporosis? Curr Osteoporos Rep. 2017;15:194–7.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Mazzaferro S, Goldsmith D, Larsson TE, Massy ZA, Cozzolino M. Vitamin D metabolites and/or analogs: which D for which patient? Curr Vasc Pharmacol. 2014;12:339–49.

    Article  CAS  PubMed  Google Scholar 

  89. Andress DL, Keith MD, Norris C, et al. Intravenous calcitriol in the treatment of refractory osteitis fibrosa of chronic renal failure. N Engl J Med. 1989;321:274–9.

    Article  CAS  PubMed  Google Scholar 

  90. Bover J, Cozzolino M. Mineral and bone disorders in chronic kidney disease and end-stage renal disease patients: new insights into vitamin D receptor activation. Kidney Int Suppl. 2011;1:122–9.

    Article  CAS  Google Scholar 

  91. Behets GJ, Spasovski G, Sterling LR, et al. Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism. Kidney Int. 2015;87:846–56.

    Article  CAS  PubMed  Google Scholar 

  92. Sumida K, Ubara Y, Hoshino J, Mise K, Hayami N, Suwabe T, et al. Once-weekly teriparatide in hemodialysis patients with hypoparathyroidism and low bone mass: a prospective study. Osteoporos Int. 2016;27:1441–50.

    Article  CAS  PubMed  Google Scholar 

  93. Chen CL, Chen NC, Hsu CY, et al. An open-label, prospective pilot clinical study of denosumab for severe hyperparathyroidism in patients with ow bone mass undergoing dialysis. J Clin Endocrinol Metab. 2014;99:2426–32.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unit of Nephrology, Dipartimento di Scienze Cardiovascolari Respiratorie Nefrologiche Anestesiologiche e Geriatriche, Azienda Policlinico Umberto I, Sapienza Università di Roma, Rome, Italy

    Sandro Mazzaferro, Silverio Rotondi, Lida Tartaglione, Natalia De Martino, Cristiana Leonangeli & Marzia Pasquali

Authors
  1. Sandro Mazzaferro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silverio Rotondi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lida Tartaglione
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Natalia De Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cristiana Leonangeli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marzia Pasquali
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandro Mazzaferro .

Editor information

Editors and Affiliations

  1. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

    Andrea Lenzi

  2. Department of Movement, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy

    Silvia Migliaccio

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Mazzaferro, S., Rotondi, S., Tartaglione, L., De Martino, N., Leonangeli, C., Pasquali, M. (2018). Renal Diseases and Skeletal Health. In: Lenzi, A., Migliaccio, S. (eds) Multidisciplinary Approach to Osteoporosis. Springer, Cham. https://doi.org/10.1007/978-3-319-75110-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-75110-8_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75108-5

  • Online ISBN: 978-3-319-75110-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation