Kas İskelet Sistemi ve Kemik Sağlığı (Kronik Böbrek Hastalığında Renal Osteodistrofi)
Özet
Kronik böbrek hastalığı, böbreklerin birincil hastalığı veya diğer sistemik hastalıkların ikincil etkisi ile gelişen, ilerleyici fonksiyon kaybına neden olan, kardiyovasküler hastalık ve erken ölümle sonuçlanan bir hastalıktır. Mineral ve kemik metabolizması bozuklukları sıklıkla görülmektedir. Bu hastalarda iskelet sisteminde gelişen komplikasyonların bütününü tanımlayan Renal Osteodistrofi, temelde böbrek fonksiyon bozukluğuna bağlı gelişen çeşitli mineral metabolizma ve denge bozukluklarının neden olduğu kronik komplikasyondur. KBH hastalarında mineraller (kalsiyum, fosfor), hormon [parathormon] ve vitamin [vitamin D] düzeylerinde değişiklikler gelişir. Bu değişiklikler kemik morfolojisinde ve mimarisinde negatif etki oluştururlar. Yine bu değişiklikler KBH hastalarında birincil mortalite nedeni olan kardiyovasküler hastalık ve vasküler kalsifikasyon gelişimine pozitif olarak etki eder. KBH’da gelişen mineral metabolizma değişikliklerinin kemik yapı ve diğer sistemik etkilerini kapsayan isimlendirme olan Kronik Böbrek Hastalığı-Mineral Kemik Hastalığı (KBH-MKH), kemik yapıdaki morfolojik değişimi ve vasküler başta olmak üzere diğer yumuşak dokularda gelişen kalsifikasyon gelişimini ifade etmektedir. Renal osteodistrofi tanısı kemik biyopsi histomorfometrisi ile kesin olarak konulur. Fakat çoğu zaman biyopsi yapılması düşünülmez. Serum Ca, P, Pth ve VitD düzey ve metabolizmalarında oluşan değişimler, kemik mineralizasyonu-döngüsü ve fizyolojisine etki ederek kemik hastalığına neden olur. Ayrıca vasküler ve diğer dokularda kalsifikasyon gelişimine neden olan bu değişimler glomerül filtrasyon hızı (GFR) 40 ml/dk altına düştüğünde belirgin olarak ortaya çıkmaktadır.
Chronic kidney disease is a primary disease of the kidneys or a secondary effect of other systemic diseases, leading to progressive loss of function, cardiovascular disease, and early death. Mineral and bone metabolism disorders are frequently observed. Renal Osteodystrophy, which defines all of the complications that develop in the skeletal system in these patients, is a chronic complication caused by various mineral metabolism and balance disorders that develop mainly due to renal dysfunction. CKD patients develop changes in mineral (calcium, phosphorus), hormone [parathormone], and vitamin [vitamin D] levels. These changes harm bone morphology and architecture. These changes also have a positive effect on the development of cardiovascular disease and vascular calcification, which is the primary cause of mortality in CKD patients. Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD), which is the nomenclature covering the bone structure and other systemic effects of mineral metabolism changes in CKD, refers to the morphologic change in bone structure and the development of calcification in other soft tissues, especially vascular. The diagnosis of renal osteodystrophy is definitively established by bone biopsy histomorphometry. However, biopsy is often not considered. Changes in serum Ca, P, Pth and VitD levels and metabolism affect bone mineralization-cycle and physiology and cause bone disease. These changes, which also cause the development of calcification in vascular and other tissues, are evident when the glomerular filtration rate (GFR) falls below 40 ml/min.
Referanslar
Eknoyan G, Lameire N, Barsoum R et al. The burden of kidney disease: improving global outcomes. Kidney Int 2004; 66: 1310–1314.
Shah A, Hashmi MF, Aeddula NR. Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD). 2024 Apr 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32809577.
Moe S, Drüeke T, Cunningham J, et al. Kidney Disease: Improving Global Outcomes (KDIGO). Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006 Jun;69(11):1945-53. doi: 10.1038/sj.ki.5000414. PMID: 16641930.
Shah A, Hashmi MF, Aeddula NR. Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD). 2024 Apr 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32809577.
Block GA, Cunningham J. Morbidity and mortality associated with abnormalities in bone and mineral metabolism in CKD. In: Olgaard K (ed). Clinical Guide to the Basics of Bone and Mineral Metabolism in CKD. chapter 4 National Kidney Foundation: New York, 2006, pp 77–92.
Isakova T, Cai X, Lee J, et al. CRIC Study Investigators. Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2020 Feb;75(2):235-244.
Hruska KA, Mathew S, Lund R, et al. Hyperphosphatemia of chronic kidney disease. Kidney Int. 2008 Jul;74(2):148-57. doi: 10.1038/ki.2008.130. Epub 2008 Apr 30. PMID: 18449174; PMCID: PMC2735026.
Craver L, Marco MP, Martínez I, et al. Mineral metabolism parameters throughout chronic kidney disease stages 1-5--achievement of K/DOQI target ranges. Nephrol Dial Transplant. 2007 Apr;22(4):1171-6. doi: 10.1093/ndt/gfl718. Epub 2007 Jan 5. PMID: 17205962.
Slatopolsky E, Gonzalez E, Martin K. Pathogenesis and treatment of renal osteodystrophy. Blood Purif. 2003;21(4-5):318-26. doi: 10.1159/000072552. PMID: 12944733.
Denda M, Finch J, Slatopolsky E: Phosphorus accelerates the development of parathyroid hyperplasia and secondary hyperparathyroidism in rats with renal failure. Am J Kidney Dis 1996;28:596–602.
Ho LT, Sprague SM. Renal osteodystrophy in chronic renal failure. Semin Nephrol. 2002 Nov;22(6):488-93. doi: 10.1053/snep.2002.35965. PMID: 12430093.
Wetmore JB, Liu S, Krebill R, et al. Effects of cinacalcet and concurrent low-dose vitamin D on FGF23 levels in ESRD. Clin J Am Soc Nephrol. 2010 Jan;5(1):110-6. doi: 10.2215/CJN.03630509. Epub 2009 Nov 5. PMID: 19965548; PMCID: PMC2801647.
Yamada S, Giachelli CM. Vascular calcification in CKD-MBD: Roles for phosphate, FGF23, and Klotho. Bone. 2017 Jul;100:87-93. doi: 10.1016/j.bone.2016.11.012. Epub 2016 Nov 12. PMID: 27847254; PMCID: PMC5429216.
Goltzman D, Mannstadt M, Marcocci C. Physiology of the Calcium-Parathyroid Hormone-Vitamin D Axis. Front Horm Res. 2018;50:1-13. doi: 10.1159/000486060. Epub 2018 Mar 29. PMID: 29597231.
Cunningham J, Locatelli F, Rodriguez M. Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options. Clin J Am Soc Nephrol. 2011 Apr;6(4):913-21. doi: 10.2215/CJN.06040710. Epub 2011 Mar 31. PMID: 21454719.
Drueke T, Martin D, Rodriguez M. Can calcimimetics inhibit parathyroid hyperplasia? Evidence from preclinical studies. Nephrol Dial Transplant. 2007 Jul;22(7):1828-39. doi: 10.1093/ndt/gfm177. Epub 2007 Apr 20. PMID: 17449493.
Moe SM, Chen NX. Pathophysiology of vascular calcification in chronic kidney disease. Circ Res. 2004 Sep 17;95(6):560-7. doi: 10.1161/01.RES.0000141775.67189.98. PMID: 15375022.
Rodriguez M, Nemeth E, Martin D. The calcium-sensing receptor: a key factor in the pathogenesis of secondary hyperparathyroidism. Am J Physiol Renal Physiol. 2005 Feb;288(2):F253-64. doi: 10.1152/ajprenal.00302.2004. Epub 2004 Oct 26. PMID: 15507543.
DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1689S-96S. doi: 10.1093/ajcn/80.6.1689S. PMID: 15585789.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81. doi: 10.1056/NEJMra070553. PMID: 17634462.
Brown AJ. Vitamin D analogs for secondary hyperparathyroidism: what does the future hold? J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):578-83. doi: 10.1016/j.jsbmb.2006.12.089. Epub 2006 Dec 27. PMID: 17368185.
Slatopolsky E, Weerts C, Thielan J, Horst R, Harter H, Martin KJ. Marked suppression of secondary hyperparathyroidism by intravenous administration of 1,25-dihydroxy-cholecalciferol in uremic patients. J Clin Invest. 1984 Dec;74(6):2136-43. doi: 10.1172/JCI111639. PMID: 6549016; PMCID: PMC425405.
Isakova T, Wahl P, Vargas GS, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011 Jun;79(12):1370-8. doi: 10.1038/ki.2011.47. Epub 2011 Mar 9. Erratum in: Kidney Int. 2012 Aug;82(4):498. PMID: 21389978; PMCID: PMC3134393.
Tatsumi S, Miyagawa A, Kaneko I, et al. Regulation of renal phosphate handling: inter-organ communication in health and disease. J Bone Miner Metab. 2016 Jan;34(1):1-10. doi: 10.1007/s00774-015-0705-z. Epub 2015 Aug 22. PMID: 26296817.
Ben-Dov IZ, Galitzer H, Lavi-Moshayoff V, et al. The parathyroid is a target organ for FGF23 in rats. J Clin Invest. 2007 Dec;117(12):4003-8. doi: 10.1172/JCI32409. PMID: 17992255; PMCID: PMC2066196.
Blau JE, Collins MT. The PTH-Vitamin D-FGF23 axis. Rev Endocr Metab Disord. 2015 Jun;16(2):165-74. doi: 10.1007/s11154-015-9318-z. PMID: 26296372.
Grabner A, Amaral AP, Schramm K, et al. Activation of Cardiac Fibroblast Growth Factor Receptor 4 Causes Left Ventricular Hypertrophy. Cell Metab. 2015 Dec 1;22(6):1020-32. doi: 10.1016/j.cmet.2015.09.002. Epub 2015 Oct 1. PMID: 26437603; PMCID: PMC4670583.
Hruska KA, Teitelbaum SL. Renal osteodystrophy. N Engl J Med. 1995 Jul 20;333(3):166-74. doi: 10.1056/NEJM199507203330307. PMID: 7791820.
Naji Rad S, Anastasopoulou C, Barnett MJ, Deluxe L. Osteitis Fibrosa Cystica. 2023 Nov 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644523.
Naveh-Many T, Rahamimov R, Livni N, Silver J. Parathyroid cell proliferation in normal and chronic renal failure rats. The effects of calcium, phosphate, and vitamin D. J Clin Invest. 1995 Oct;96(4):1786-93. doi: 10.1172/JCI118224. PMID: 7560070; PMCID: PMC185815.
Brandenburg VM, Floege J. Adynamic bone disease-bone and beyond. NDT Plus. 2008 Jun;1(3):135-47. doi: 10.1093/ndtplus/sfn040. PMID: 25983860; PMCID: PMC4421169.
Stathi D, Fountoulakis N, Panagiotou A, et al. Impact of treatment with active vitamin D calcitriol on bone turnover markers in people with type 2 diabetes and stage 3 chronic kidney disease. Bone. 2023 Jan;166:116581. doi: 10.1016/j.bone.2022.116581. Epub 2022 Oct 8. PMID: 36216304.
Nebeker HG, Coburn JW. Aluminum and renal osteodystrophy. Annu Rev Med. 1986;37:79-95. doi: 10.1146/annurev.me.37.020186.000455. PMID: 3085581.
Moody WE, Edwards NC, Chue CD, Ferro CJ, Townend JN. Arterial disease in chronic kidney disease. Heart. 2013 Mar;99(6):365-72. doi: 10.1136/heartjnl-2012-302818. Epub 2012 Oct 31. PMID: 23118349.
Westphal SG, Plumb T. Calciphylaxis. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30085562.
Kemper MJ, van Husen M. Renal osteodystrophy in children: pathogenesis, diagnosis and treatment. Curr Opin Pediatr. 2014 Apr;26(2):180-6. doi: 10.1097/MOP.0000000000000061. PMID: 24553631.
Donoso-Hofer F, Gunther-Wood M, Romero-Romano P, et al. Uremic leontiasis ossea, a rare presentation of severe renal osteodystrophy secondary to hyperparathyroidism. J Stomatol Oral Maxillofac Surg. 2018 Feb;119(1):56-60. doi: 10.1016/j.jormas.2017.10.006. Epub 2017 Oct 14. PMID: 29037869.
Schwarz C, Sulzbacher I, Oberbauer R. Diagnosis of renal osteodystrophy. Eur J Clin Invest. 2006 Aug;36 Suppl 2:13-22. doi: 10.1111/j.1365-2362.2006.01666.x. PMID: 16884394.
Moorthi RN, Armstrong CL, Janda K, Ponsler-Sipes K, Asplin JR, Moe SM. The effect of a diet containing 70% protein from plants on mineral metabolism and musculoskeletal health in chronic kidney disease. Am J Nephrol. 2014;40(6):582-91.
Meng L, Fu B. Practical use of sevelamer in chronic kidney disease patients on dialysis in People's Republic of China. Ther Clin Risk Manag. 2015;11:705-12.
National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003 Oct;42(4 Suppl 3):S1-201.
Hill KM, Martin BR, Wastney ME, McCabe GP, Moe SM, Weaver CM, Peacock M. Oral calcium carbonate affects calcium but not phosphorus balance in stage 3-4 chronic kidney disease. Kidney Int. 2013 May;83(5):959-66.
Kramer H, Berns JS, Choi MJ, Martin K, Rocco MV. 25-Hydroxyvitamin D testing and supplementation in CKD: an NKF-KDOQI controversies report. Am J Kidney Dis. 2014 Oct;64(4):499-509.
Thadhani R, Appelbaum E, Pritchett Y, et al. Vitamin D therapy and cardiac structure and function in patients with chronic kidney disease: the PRIMO randomized controlled trial. JAMA. 2012 Feb 15;307(7):674-84.
Jindal K, Chan CT, Deziel C, Hirsch D, Soroka SD, Tonelli M, Culleton BF., Canadian Society of Nephrology Committee for Clinical Practice Guidelines. Hemodialysis clinical practice guidelines for the Canadian Society of Nephrology. J Am Soc Nephrol. 2006 Mar;17(3 Suppl 1):S1-27.
Ketteler M, Blok GA, Evenepoel P, Fukagawa M, Herzog CA, McCann L, Moe SM, Shroff R, Tonelli MA, Toussaint ND, Vervloet MG, Leonard MB. 2017 KDIGO Kronik Böbrek Hastalığı-Mineral ve Kemik Bozukluğu (KBH-MBD) Kılavuz Güncellemesinin yönetici özeti: neler değişti ve neden önemli? Böbrek Int. 2017 Temmuz; 92(1):26-36.
Floege J, Kim J, Ireland E, et al. Serum iPTH, calcium and phosphate, and the risk of mortality in a European haemodialysis population. Nephrol Dial Transplant. 2011 Jun;26(6):1948-55.
Mailliez S, Shahapuni I, Lecaque C, et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 2008 Aug;74(3):389; author reply 389.
Palmer SC, Mavridis D, Johnson DW, et al. Comparative Effectiveness of Calcimimetic Agents for Secondary Hyperparathyroidism in Adults: A Systematic Review and Network Meta-analysis. Am J Kidney Dis. 2020 Sep;76(3):321-330.
Palmer SC, Nistor I, Craig JC, Pellegrini F, Messa P, Tonelli M, Covic A, Strippoli GF. Cinacalcet in patients with chronic kidney disease: a cumulative meta-analysis of randomized controlled trials. PLoS Med. 2013;10(4):e1001436.
Referanslar
Eknoyan G, Lameire N, Barsoum R et al. The burden of kidney disease: improving global outcomes. Kidney Int 2004; 66: 1310–1314.
Shah A, Hashmi MF, Aeddula NR. Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD). 2024 Apr 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32809577.
Moe S, Drüeke T, Cunningham J, et al. Kidney Disease: Improving Global Outcomes (KDIGO). Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006 Jun;69(11):1945-53. doi: 10.1038/sj.ki.5000414. PMID: 16641930.
Shah A, Hashmi MF, Aeddula NR. Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD). 2024 Apr 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32809577.
Block GA, Cunningham J. Morbidity and mortality associated with abnormalities in bone and mineral metabolism in CKD. In: Olgaard K (ed). Clinical Guide to the Basics of Bone and Mineral Metabolism in CKD. chapter 4 National Kidney Foundation: New York, 2006, pp 77–92.
Isakova T, Cai X, Lee J, et al. CRIC Study Investigators. Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2020 Feb;75(2):235-244.
Hruska KA, Mathew S, Lund R, et al. Hyperphosphatemia of chronic kidney disease. Kidney Int. 2008 Jul;74(2):148-57. doi: 10.1038/ki.2008.130. Epub 2008 Apr 30. PMID: 18449174; PMCID: PMC2735026.
Craver L, Marco MP, Martínez I, et al. Mineral metabolism parameters throughout chronic kidney disease stages 1-5--achievement of K/DOQI target ranges. Nephrol Dial Transplant. 2007 Apr;22(4):1171-6. doi: 10.1093/ndt/gfl718. Epub 2007 Jan 5. PMID: 17205962.
Slatopolsky E, Gonzalez E, Martin K. Pathogenesis and treatment of renal osteodystrophy. Blood Purif. 2003;21(4-5):318-26. doi: 10.1159/000072552. PMID: 12944733.
Denda M, Finch J, Slatopolsky E: Phosphorus accelerates the development of parathyroid hyperplasia and secondary hyperparathyroidism in rats with renal failure. Am J Kidney Dis 1996;28:596–602.
Ho LT, Sprague SM. Renal osteodystrophy in chronic renal failure. Semin Nephrol. 2002 Nov;22(6):488-93. doi: 10.1053/snep.2002.35965. PMID: 12430093.
Wetmore JB, Liu S, Krebill R, et al. Effects of cinacalcet and concurrent low-dose vitamin D on FGF23 levels in ESRD. Clin J Am Soc Nephrol. 2010 Jan;5(1):110-6. doi: 10.2215/CJN.03630509. Epub 2009 Nov 5. PMID: 19965548; PMCID: PMC2801647.
Yamada S, Giachelli CM. Vascular calcification in CKD-MBD: Roles for phosphate, FGF23, and Klotho. Bone. 2017 Jul;100:87-93. doi: 10.1016/j.bone.2016.11.012. Epub 2016 Nov 12. PMID: 27847254; PMCID: PMC5429216.
Goltzman D, Mannstadt M, Marcocci C. Physiology of the Calcium-Parathyroid Hormone-Vitamin D Axis. Front Horm Res. 2018;50:1-13. doi: 10.1159/000486060. Epub 2018 Mar 29. PMID: 29597231.
Cunningham J, Locatelli F, Rodriguez M. Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options. Clin J Am Soc Nephrol. 2011 Apr;6(4):913-21. doi: 10.2215/CJN.06040710. Epub 2011 Mar 31. PMID: 21454719.
Drueke T, Martin D, Rodriguez M. Can calcimimetics inhibit parathyroid hyperplasia? Evidence from preclinical studies. Nephrol Dial Transplant. 2007 Jul;22(7):1828-39. doi: 10.1093/ndt/gfm177. Epub 2007 Apr 20. PMID: 17449493.
Moe SM, Chen NX. Pathophysiology of vascular calcification in chronic kidney disease. Circ Res. 2004 Sep 17;95(6):560-7. doi: 10.1161/01.RES.0000141775.67189.98. PMID: 15375022.
Rodriguez M, Nemeth E, Martin D. The calcium-sensing receptor: a key factor in the pathogenesis of secondary hyperparathyroidism. Am J Physiol Renal Physiol. 2005 Feb;288(2):F253-64. doi: 10.1152/ajprenal.00302.2004. Epub 2004 Oct 26. PMID: 15507543.
DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1689S-96S. doi: 10.1093/ajcn/80.6.1689S. PMID: 15585789.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007 Jul 19;357(3):266-81. doi: 10.1056/NEJMra070553. PMID: 17634462.
Brown AJ. Vitamin D analogs for secondary hyperparathyroidism: what does the future hold? J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):578-83. doi: 10.1016/j.jsbmb.2006.12.089. Epub 2006 Dec 27. PMID: 17368185.
Slatopolsky E, Weerts C, Thielan J, Horst R, Harter H, Martin KJ. Marked suppression of secondary hyperparathyroidism by intravenous administration of 1,25-dihydroxy-cholecalciferol in uremic patients. J Clin Invest. 1984 Dec;74(6):2136-43. doi: 10.1172/JCI111639. PMID: 6549016; PMCID: PMC425405.
Isakova T, Wahl P, Vargas GS, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011 Jun;79(12):1370-8. doi: 10.1038/ki.2011.47. Epub 2011 Mar 9. Erratum in: Kidney Int. 2012 Aug;82(4):498. PMID: 21389978; PMCID: PMC3134393.
Tatsumi S, Miyagawa A, Kaneko I, et al. Regulation of renal phosphate handling: inter-organ communication in health and disease. J Bone Miner Metab. 2016 Jan;34(1):1-10. doi: 10.1007/s00774-015-0705-z. Epub 2015 Aug 22. PMID: 26296817.
Ben-Dov IZ, Galitzer H, Lavi-Moshayoff V, et al. The parathyroid is a target organ for FGF23 in rats. J Clin Invest. 2007 Dec;117(12):4003-8. doi: 10.1172/JCI32409. PMID: 17992255; PMCID: PMC2066196.
Blau JE, Collins MT. The PTH-Vitamin D-FGF23 axis. Rev Endocr Metab Disord. 2015 Jun;16(2):165-74. doi: 10.1007/s11154-015-9318-z. PMID: 26296372.
Grabner A, Amaral AP, Schramm K, et al. Activation of Cardiac Fibroblast Growth Factor Receptor 4 Causes Left Ventricular Hypertrophy. Cell Metab. 2015 Dec 1;22(6):1020-32. doi: 10.1016/j.cmet.2015.09.002. Epub 2015 Oct 1. PMID: 26437603; PMCID: PMC4670583.
Hruska KA, Teitelbaum SL. Renal osteodystrophy. N Engl J Med. 1995 Jul 20;333(3):166-74. doi: 10.1056/NEJM199507203330307. PMID: 7791820.
Naji Rad S, Anastasopoulou C, Barnett MJ, Deluxe L. Osteitis Fibrosa Cystica. 2023 Nov 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644523.
Naveh-Many T, Rahamimov R, Livni N, Silver J. Parathyroid cell proliferation in normal and chronic renal failure rats. The effects of calcium, phosphate, and vitamin D. J Clin Invest. 1995 Oct;96(4):1786-93. doi: 10.1172/JCI118224. PMID: 7560070; PMCID: PMC185815.
Brandenburg VM, Floege J. Adynamic bone disease-bone and beyond. NDT Plus. 2008 Jun;1(3):135-47. doi: 10.1093/ndtplus/sfn040. PMID: 25983860; PMCID: PMC4421169.
Stathi D, Fountoulakis N, Panagiotou A, et al. Impact of treatment with active vitamin D calcitriol on bone turnover markers in people with type 2 diabetes and stage 3 chronic kidney disease. Bone. 2023 Jan;166:116581. doi: 10.1016/j.bone.2022.116581. Epub 2022 Oct 8. PMID: 36216304.
Nebeker HG, Coburn JW. Aluminum and renal osteodystrophy. Annu Rev Med. 1986;37:79-95. doi: 10.1146/annurev.me.37.020186.000455. PMID: 3085581.
Moody WE, Edwards NC, Chue CD, Ferro CJ, Townend JN. Arterial disease in chronic kidney disease. Heart. 2013 Mar;99(6):365-72. doi: 10.1136/heartjnl-2012-302818. Epub 2012 Oct 31. PMID: 23118349.
Westphal SG, Plumb T. Calciphylaxis. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30085562.
Kemper MJ, van Husen M. Renal osteodystrophy in children: pathogenesis, diagnosis and treatment. Curr Opin Pediatr. 2014 Apr;26(2):180-6. doi: 10.1097/MOP.0000000000000061. PMID: 24553631.
Donoso-Hofer F, Gunther-Wood M, Romero-Romano P, et al. Uremic leontiasis ossea, a rare presentation of severe renal osteodystrophy secondary to hyperparathyroidism. J Stomatol Oral Maxillofac Surg. 2018 Feb;119(1):56-60. doi: 10.1016/j.jormas.2017.10.006. Epub 2017 Oct 14. PMID: 29037869.
Schwarz C, Sulzbacher I, Oberbauer R. Diagnosis of renal osteodystrophy. Eur J Clin Invest. 2006 Aug;36 Suppl 2:13-22. doi: 10.1111/j.1365-2362.2006.01666.x. PMID: 16884394.
Moorthi RN, Armstrong CL, Janda K, Ponsler-Sipes K, Asplin JR, Moe SM. The effect of a diet containing 70% protein from plants on mineral metabolism and musculoskeletal health in chronic kidney disease. Am J Nephrol. 2014;40(6):582-91.
Meng L, Fu B. Practical use of sevelamer in chronic kidney disease patients on dialysis in People's Republic of China. Ther Clin Risk Manag. 2015;11:705-12.
National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003 Oct;42(4 Suppl 3):S1-201.
Hill KM, Martin BR, Wastney ME, McCabe GP, Moe SM, Weaver CM, Peacock M. Oral calcium carbonate affects calcium but not phosphorus balance in stage 3-4 chronic kidney disease. Kidney Int. 2013 May;83(5):959-66.
Kramer H, Berns JS, Choi MJ, Martin K, Rocco MV. 25-Hydroxyvitamin D testing and supplementation in CKD: an NKF-KDOQI controversies report. Am J Kidney Dis. 2014 Oct;64(4):499-509.
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