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Is Adynamic Bone Always a Disease? Lessons from Patients with Chronic Kidney Disease
Eman Nagy1, Mahmoud M Sobh1, Mohamed Abdalbary1
1Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt.
Journal of Clinical Medicine
|December 11, 2022
Summary
Adynamic bone (ADB) is increasingly prevalent in chronic kidney disease (CKD), but its role as a disease or adaptive mechanism remains unclear. Further research is needed to understand its impact on bone health and survival in CKD patients.
Area of Science:
- Nephrology
- Bone Metabolism
- Pathophysiology
Background:
- Renal osteodystrophy (ROD) is a common complication in chronic kidney disease (CKD).
- Adynamic bone (ADB) is characterized by suppressed bone formation and low cellularity, with increasing prevalence in early CKD.
- The exact nature of ADB—whether a disease, adaptive mechanism, or transitional stage—is not well understood.
Purpose of the Study:
- To review current knowledge on Adynamic Bone (ADB).
- To discuss the impact of ADB on bone health, fracture risk, vascular calcification, and survival in CKD patients.
- To emphasize preventive and management strategies for ADB in CKD.
Main Methods:
- Literature review of up-to-date knowledge on Adynamic Bone (ADB).
- Discussion of pathogenesis, clinical impact, and management strategies for ADB in CKD.
Main Results:
- Evidence suggests an increasing prevalence of ADB, particularly in early CKD.
- ADB's role in pathogenesis involves factors like age, diabetes, malnutrition, uremia, and iatrogenic causes.
- The clinical impact of ADB on bone health, fracture risk, vascular calcification, and survival requires further investigation.
Conclusions:
- The precise role of ADB in CKD remains uncertain, with ongoing debate about its pathological or adaptive nature.
- Effective management and prevention strategies for ADB are crucial for CKD patient care.
- More research is essential to clarify the implications of ADB in patients with chronic kidney disease.
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