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Bone biopsy in renal osteodystrophy: continued insights into a complex disease
Marta Christov1, Renata Pereira, Kate Wesseling-Perry
1Division of Nephrology, Beth Israel Deaconess Medical Center and Division of Endocrinology, Massachusetts General Hospital, Boston, Massachusetts, USA. mchrist3@bidmc.harvard.edu
Current Opinion in Nephrology and Hypertension
|January 16, 2013
Summary
Renal bone disease in chronic kidney disease (CKD) is complex and starts early. Bone biopsy reveals unexpected effects of therapies on bone, highlighting the need for personalized treatment approaches for CKD patients.
Area of Science:
- Nephrology
- Bone Biology
- Mineral Metabolism
Background:
- Renal bone disease pathogenesis and therapy are poorly understood in chronic kidney disease (CKD) and dialysis patients.
- Bone biopsy offers critical insights into cellular and molecular bone events.
- Abnormalities in bone physiology in CKD manifest early, often before measurable mineral metabolism changes.
Purpose of the Study:
- To review recent insights into renal bone disease pathophysiology using bone biopsy data.
- To discuss the implications of these findings for optimizing treatment strategies.
- To highlight the early onset and complexity of bone abnormalities in CKD.
Main Methods:
- Review of bone biopsy studies.
- Analysis of recent literature on renal osteodystrophy.
- Examination of cellular and molecular events in bone.
Main Results:
- Bone abnormalities begin early in CKD, even with normal mineral metabolism markers.
- Racial differences in bone pathology are observed, suggesting limitations in current treatment guidelines.
- Therapies for secondary hyperparathyroidism can have unanticipated effects on bone.
Conclusions:
- Bone biopsy studies are crucial for understanding the molecular pathogenesis of renal osteodystrophy.
- Current therapeutic interventions may yield unexpected consequences for bone physiology.
- Further research is needed to refine treatment strategies for renal bone disease in CKD.
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