Precision Renal Osteodystrophy: What's Race Got to do With It?

Area of Science:

• Nephrology
• Orthopedics
• Genetics

Background:

• Racial-ethnic disparities in bone health are well-documented.
• These differences are observed in both the general population and patients with chronic kidney disease (CKD).
• Historical data primarily focused on Black and White populations, but recent findings reveal more complex variations.

Purpose of the Study:

• To highlight race and ethnicity as critical factors necessitating precision medicine in managing renal osteodystrophy.
• To underscore the need for individualized treatment approaches in bone disease associated with kidney dysfunction.

Main Methods:

• Review of existing literature on racial-ethnic differences in bone health.
• Analysis of recent data on fracture risk and skeletal biomarkers across different racial groups.
• Examination of skeletal microarchitecture variations in relation to race and CKD.

Main Results:

• Persistent racial-ethnic differences in bone health and fracture risk are evident in current data for healthy and CKD populations.
• Recent findings indicate a more intricate pattern of skeletal differences by race than previously understood.
• Numerous studies confirm racial disparities in skeletal microarchitecture, fracture risk, and biomarkers, yet the exact causes remain unclear.

Conclusions:

• Race serves as a prominent example illustrating the necessity of precision medicine for treating renal osteodystrophy.
• Further research is required to elucidate the etiology of racial differences in bone health.
• Precision medicine approaches are essential to provide individualized treatments for renal osteodystrophy, irrespective of a patient's race.