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Related Experiment Video

Updated: Jan 14, 2026

Murine Hind Limb Long Bone Dissection and Bone Marrow Isolation
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Anaemia and bone disease.

Karen Van1, Jasna Aleksova1, Phillip Wong2

  • 1Department of Endocrinology, Monash Health, Clayton, Vic, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Vic, Australia; Hudson Institute of Medical Research, Clayton, Vic, Australia.

Pathology
|January 12, 2026
PubMed
Summary
This summary is machine-generated.

Anaemia and bone disease are linked, with fibroblast growth factor-23 (FGF-23) impacting both. This review highlights under-recognized bone risks in anaemia patients and offers monitoring recommendations.

Keywords:
anaemiabonechronic kidney diseasefibroblast growth factor-23fractureironosteoporosisthalassaemia

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Area of Science:

  • Bone Metabolism and Endocrinology
  • Hematology
  • Mineral Metabolism

Background:

  • Anaemia and bone disease frequently coexist in chronic conditions like haemoglobinopathies and chronic kidney disease.
  • Bone health is compromised by factors such as marrow expansion, iron overload, endocrine dysfunction, and mineral metabolism disruptions, increasing fracture risk.
  • Current therapeutic advances for anaemia may have under-recognized effects on bone health, with osteoporosis often detected post-fracture.

Purpose of the Study:

  • To review the bi-directional relationship between anaemia and bone metabolism.
  • To highlight the role of fibroblast growth factor-23 (FGF-23) as a key link between anaemia, phosphate regulation, and bone health.
  • To draw attention to under-recognized skeletal risks and provide practical monitoring recommendations.

Main Methods:

  • Literature review focusing on the interplay between anaemia, bone metabolism, and FGF-23.
  • Analysis of current therapeutic strategies for anaemia and their skeletal implications.
  • Synthesis of mechanistic insights with clinical practice for monitoring bone health.

Main Results:

  • Fibroblast growth factor-23 (FGF-23) plays a central role in linking anaemia, phosphate regulation, and bone metabolism.
  • Concurrent use of anti-resorptives (like denosumab) and parenteral iron may lead to hypophosphataemia, an under-appreciated complication.
  • Existing guidelines for monitoring bone health in anaemic patients are limited.

Conclusions:

  • There is a critical need to recognize the skeletal risks associated with anaemia and its treatments.
  • Monitoring FGF-23 and phosphate levels is crucial, especially in patients receiving combined anti-resorptive and parenteral iron therapies.
  • Practical recommendations are provided to bridge mechanistic understanding with clinical practice for improved bone health management in anaemic patients.