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Longitudinal Evaluation of Mouse Hind Limb Bone Loss After Spinal Cord Injury using Novel, in vivo, Methodology
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Renal insufficiency and bone loss

Susan M Ott1

  • 1Department of Medicine, University of Washington, Seattle, Washington, USA.

Current Opinion in Rheumatology
|May 29, 2019
PubMed
Abstract

Insights

Patients with chronic kidney disease (CKD) face high fracture risks due to complex bone disease. Recent discoveries in signaling pathways offer potential for novel CKD bone disease treatments.

Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Chronic kidney disease (CKD) patients exhibit a high incidence of fractures.
  • Established treatments for CKD-related bone disease are lacking.
  • Mineral metabolism in CKD is complicated by newly identified factors, including vascular calcifications linked to bone disease.

Purpose of the Study:

  • To review the complex physiology of renal osteodystrophy.
  • To highlight recent findings in signaling pathways affecting bone disease in CKD.
  • To discuss the challenges and potential future directions for treating bone disease in CKD patients.

Main Methods:

  • Review of current literature on CKD-related bone disease.
  • Analysis of signaling pathways (Wnt, activin) and hormones (FGF-23, klotho) in CKD.
  • Evaluation of clinical studies on hyperparathyroidism and phosphate management.

Main Results:

  • Wnt and activin signaling pathways are implicated early in renal disease, influencing bone physiology.
  • Increased FGF-23 levels affect phosphate secretion and have systemic effects.
  • Secreted klotho is a newly identified hormone with multi-systemic effects.
  • Current treatments for hyperparathyroidism and phosphate have limitations.

Conclusions:

  • Treating bone disease in CKD patients remains a significant clinical challenge.
  • Understanding the intricate physiological pathways is crucial for developing novel therapeutic strategies.
  • Further research into signaling pathways and hormonal regulation may unlock new treatment avenues for CKD-associated bone disease.

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