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Published in:

01-09-2012 | Original Paper

Biochemical Abnormalities in Chronic Kidney Disease–Mineral Bone Disease

Author: Lavinia A. Negrea

Published in: Clinical & Translational Metabolism | Issue 3/2012

Abstract

Chronic kidney disease–mineral and bone disorders (CKD-MBD) is a term introduced by the Kidney Disease: Improving Global Outcomes (KDIGO) work group on mineral and bone disorder as a syndrome of interrelated biochemical, bone, and vascular abnormalities encountered in CKD. Biochemical abnormalities in CKD represent primary indicators for the diagnosis and management of CKD-MBD. This review discusses each abnormality separately, with references to both the Kidney Dialysis Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease and KDIGO Guidelines for Mineral and Bone Disorder. Selected references to the association between biochemical abnormalities and adverse clinical outcomes in CKD population are provided.

Hruska K, Mathew S, Lund R, Fang Y, Sugatani T. Cardiovascular risk factors in chronic kidney disease: does phosphate qualify? Kidney Int Suppl. 2011;(121):S9–S13. Epub 2011 Feb 23.

Moe S, Drüeke T, Cunningham J, Goodman W, Martin K, Olgaard K, Ott S, Sprague S, Lameire N, Eknoyan G. 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;69(11):1945–53.PubMedCrossRef

Gutiérrez OM. Fibroblast growth factor 23 and disordered vitamin D metabolism in chronic kidney disease: updating the “trade-off” hypothesis. Clin J Am Soc Nephrol. 2010;5(9):1710–6.PubMedCrossRef

Goldsmith DJ, Cunningham J. Mineral metabolism and vitamin D in chronic kidney disease–more questions than answers. Nat Rev Nephrol. 2011;7(6):341–6.PubMedCrossRef

Vokes TJ. Blood calcium, phosphate and magnesium. In: Favus MJ, editor. Primer on the metabolic bone diseases and disorders of the mineral metabolism, vol. 6. Philadelphia: Lippincott-Raven; 2006. p. 123–7.

Hruska KA, Mathew S, Lund R, Qiu P, Pratt R. Hyperphosphatemia of chronic kidney disease. Kidney Int. 2008;74(2):148–57.PubMedCrossRef

Levin A, Bakris GL, Molitch M, Smulders M, Tian J, Williams LA, Andress DL. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int. 2007;71(1):31–38. Epub 2006 Nov 8. Erratum in: Kidney Int. 2009 75(11):1237.

Moranne O, Froissart M, Rossert J, Gauci C, Boffa JJ, Haymann JP, M’rad MB, Jacquot C, Houillier P, Stengel B, Fouqueray B. Nephrotest study group. Timing of onset of CKD-related metabolic complications. J Am Soc Nephrol. 2009;20(1):164–71.PubMedCrossRef

National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(4 Suppl 3):S1–201.

10.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2009;76(Suppl 113):S1–130.

11.

Dhingra R, Sullivan LM, Fox CS, Wang TJ, D’Agostino RB Sr, Gaziano JM, Vasan RS. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007;167(9):879–85.PubMedCrossRef

12.

O’Seaghdha CM, Hwang SJ, Muntner P, Melamed ML, Fox CS. Serum phosphorus predicts incident chronic kidney disease and end-stage renal disease. Nephrol Dial Transplant. 2011;26(9):2885–90.PubMedCrossRef

13.

Chonchol M, Dale R, Schrier RW, Estacio R. Serum phosphorus and cardiovascular mortality in type 2 diabetes. Am J Med. 2009;122(4):380–6.PubMedCrossRef

14.

Tonelli M, Sacks F, Pfeffer M, Gao Z, Curhan G. Cholesterol and recurrent events trial investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005;112(17):2627–33.PubMedCrossRef

15.

Linefsky JP, O’Brien KD, Katz R, de Boer IH, Barasch E, Jenny NS, Siscovick DS, Kestenbaum B. Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study. J Am Coll Cardiol. 2011;58(3):291–7.PubMedCrossRef

16.

Foley RN, Collins AJ, Herzog CA, Ishani A, Kalra PA. Serum phosphorus levels associate with coronary atherosclerosis in young adults. J Am Soc Nephrol. 2009;20(2):397–404.PubMedCrossRef

17.

Foley RN, Collins AJ, Ishani A, Kalra PA. Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2008;156(3):556–63.PubMedCrossRef

18.

Zhang Y, Post WS, Dalal D, Bansal S, Blasco-Colmenares E, Jan De Beur S, Alonso A, Soliman EZ, Whitsel EA, Brugada R, Tomaselli GF, Guallar E. Serum 25-hydroxyvitamin D, calcium, phosphorus, and electrocardiographic QT interval duration: findings from NHANES III and ARIC. J Clin Endocrinol Metab. 2011;96(6):1873–82.PubMedCrossRef

19.

Kendrick J, Ix JH, Targher G, Smits G, Chonchol M. Relation of serum phosphorus levels to ankle brachial pressure index (from the third national health and nutrition examination survey). Am J Cardiol. 2010;106(4):564–8.PubMedCrossRef

20.

Ix JH, De Boer IH, Peralta CA, Adeney KL, Duprez DA, Jenny NS, Siscovick DS, Kestenbaum BR. Serum phosphorus concentrations and arterial stiffness among individuals with normal kidney function to moderate kidney disease in MESA. Clin J Am Soc Nephrol. 2009;4(3):609–15.PubMedCrossRef

21.

Bellasi A, Mandreoli M, Baldrati L, Corradini M, Di Nicolò P, Malmusi G, Santoro A. Chronic kidney disease progression and outcome according to serum phosphorus in mild-to-moderate kidney dysfunction. Clin J Am Soc Nephrol. 2011;6(4):883–91.PubMedCrossRef

22.

Zoccali C, Ruggenenti P, Perna A, Leonardis D, Tripepi R, Tripepi G, Mallamaci F, Remuzzi G; For the REIN Study Group. Phosphate may promote CKD progression and attenuate renoprotective effect of ACE inhibition. J Am Soc Nephrol. 2011 Aug 18. [Epub ahead of print].

23.

Gutiérrez OM. Increased serum phosphate and adverse clinical outcomes: unraveling mechanisms of disease. Curr Opin Nephrol Hypertens. 2011;20(3):224–8.PubMedCrossRef

24.

Kestenbaum B, Glazer NL, Köttgen A, Felix JF, Hwang SJ, Liu Y, Lohman K, Kritchevsky SB, Hausman DB, Petersen AK, Gieger C, Ried JS, Meitinger T, Strom TM, Wichmann HE, Campbell H, Hayward C, Rudan I, de Boer IH, Psaty BM, Rice KM, Chen YD, Li M, Arking DE, Boerwinkle E, Coresh J, Yang Q, Levy D, van Rooij FJ, Dehghan A, Rivadeneira F, Uitterlinden AG, Hofman A, van Duijn CM, Shlipak MG, Kao WH, Witteman JC, Siscovick DS, Fox CS. Common genetic variants associate with serum phosphorus concentration. J Am Soc Nephrol. 2010;21(7):1223–32.PubMedCrossRef

25.

Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208–18.PubMedCrossRef

26.

Kalantar-Zadeh K, Kuwae N, Regidor DL, Kovesdy CP, Kilpatrick RD, Shinaberger CS, McAllister CJ, Budoff MJ, Salusky IB, Kopple JD. Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients. Kidney Int. 2006;70(4):771–80.PubMedCrossRef

27.

Tentori F, Blayney MJ, Albert JM, Gillespie BW, Kerr PG, Bommer J, Young EW, Akizawa T, Akiba T, Pisoni RL, Robinson BM, Port FK. Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: the dialysis outcomes and practice patterns study (DOPPS). Am J Kidney Dis. 2008;52(3):519–30.PubMedCrossRef

28.

Noordzij M, Korevaar JC, Dekker FW, Boeschoten EW, Bos WJ, Krediet RT, Bossuyt PM, Geskus RB. NECOSAD study group. Mineral metabolism and mortality in dialysis patients: a reassessment of the K/DOQI guideline. Blood Purif. 2008;26(3):231–7.PubMedCrossRef

29.

Naves-Díaz M, Passlick-Deetjen J, Guinsburg A, Marelli C, Fernández-Martín JL, Rodríguez-Puyol D, Cannata-Andía JB. Calcium, phosphorus, PTH and death rates in a large sample of dialysis patients from Latin America. The CORES Study. Nephrol Dial Transplant. 2011;26(6):1938–47.PubMedCrossRef

30.

Floege J, Kim J, Ireland E, Chazot C, Drueke T, de Francisco A, Kronenberg F, Marcelli D, Passlick-Deetjen J, Schernthaner G, Fouqueray B, Wheeler DC. ARO investigators. Serum iPTH, calcium and phosphate, and the risk of mortality in a European haemodialysis population. Nephrol Dial Transplant. 2011;26(6):1948–55.PubMedCrossRef

31.

Palmer SC, Hayen A, Macaskill P, Pellegrini F, Craig JC, Elder GJ, Strippoli GF. Serum levels of phosphorus, parathyroid hormone, and calcium and risks of death and cardiovascular disease in individuals with chronic kidney disease: a systematic review and meta-analysis. JAMA. 2011;305(11):1119–27.PubMedCrossRef

32.

Martin KJ, González EA. Prevention and control of phosphate retention/hyperphosphatemia in CKD-MBD: what is normal, when to start, and how to treat? Clin J Am Soc Nephrol. 2011;6(2):440–6.PubMedCrossRef

33.

de Boer IH, Rue TC, Kestenbaum B. Serum phosphorus concentrations in the third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis. 2009;53(3):399–407.PubMedCrossRef

34.

Laflamme GH, Jowsey J. Bone and soft tissue changes with oral phosphate supplements. J Clin Invest. 1972;51(11):2834–40.PubMedCrossRef

35.

Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol. 2010;5(Suppl 1):S23–30.PubMedCrossRef

36.

Baird GS. Ionized calcium. Clin Chim Acta. 2011;412(9–10):696–701.PubMedCrossRef

37.

Morton AR, Garland JS, Holden RM. Is the calcium correct? Measuring serum calcium in dialysis patients. Semin Dial. 2010;23(3):283–9.PubMedCrossRef

38.

Gauci C, Moranne O, Fouqueray B, de la Faille R, Maruani G, Haymann JP, Jacquot C, Boffa JJ, Flamant M, Rossert J, Urena P, Stengel B, Souberbielle JC, Froissart M, Houillier P. Nephrotest study group. Pitfalls of measuring total blood calcium in patients with CKD. J Am Soc Nephrol. 2008;19(8):1592–8.PubMedCrossRef

39.

Calvi LM, Bushinsky DA. When is it appropriate to order an ionized calcium? J Am Soc Nephrol. 2008;19(7):1257–60.PubMedCrossRef

40.

Houillier P, Froissart M, Maruani G, Blanchard A. What serum calcium can tell us and what it can’t. Nephrol Dial Transplant. 2006;21(1):29–32.PubMedCrossRef

41.

Hruska KA, Mathew S. The roles of the skeleton and phosphorus in the CKD mineral bone disorder. Adv Chronic Kidney Dis. 2011;18(2):98–104.PubMedCrossRef

42.

Patel AM, Goldfarb S. Got calcium? Welcome to the calcium-alkali syndrome. J Am Soc Nephrol. 2010;21(9):1440–3.PubMedCrossRef

43.

Kurz P, Monier-Faugere MC, Bognar B, Werner E, Roth P, Vlachojannis J, Malluche HH. Evidence for abnormal calcium homeostasis in patients with adynamic bone disease. Kidney Int. 1994;46(3):855–61.PubMedCrossRef

44.

Cunningham J, Silver J. CKD-MBD: comfort in the trough of the U. Nephrol Dial Transplant. 2011;26(6):1764–6.PubMedCrossRef

45.

Kovesdy CP, Kuchmak O, Lu JL, Kalantar-Zadeh K. Outcomes associated with serum calcium level in men with non-dialysis-dependent chronic kidney disease. Clin J Am Soc Nephrol. 2010;5(3):468–76.PubMedCrossRef

46.

Stubbs JR, Wetmore JB. Does it matter how parathyroid hormone levels are suppressed in secondary hyperparathyroidism? Semin Dial. 2011;24(3):298–306.PubMedCrossRef

47.

Martin KJ, Akhtar I, González EA. Parathyroid hormone: new assays, new receptors. Semin Nephrol. 2004;24(1):3–9.PubMedCrossRef

48.

Divieti P, Inomata N, Chapin K, Singh R, Jüppner H, Bringhurst FR. Receptors for the carboxyl-terminal region of pth(1–84) are highly expressed in osteocytic cells. Endocrinology. 2001;142(2):916–25.PubMedCrossRef

49.

Salusky IB, Goodman WG, Kuizon BD, Lavigne JR, Zahranik RJ, Gales B, Wang HJ, Elashoff RM, Jüppner H. Similar predictive value of bone turnover using first- and second-generation immunometric PTH assays in pediatric patients treated with peritoneal dialysis. Kidney Int. 2003;63(5):1801–8.PubMedCrossRef

50.

Zidehsarai MP, Moe SM. Review article: Chronic kidney disease-mineral bone disorder: have we got the assays right? Nephrology (Carlton). 2009;14(4):374–82.CrossRef

51.

Souberbielle JC, Roth H, Fouque DP. Parathyroid hormone measurement in CKD. Kidney Int. 2010;77(2):93–100.PubMedCrossRef

52.

Qi Q, Monier-Faugere MC, Geng Z, Malluche HH. Predictive value of serum parathyroid hormone levels for bone turnover in patients on chronic maintenance dialysis. Am J Kidney Dis. 1995;26(4):622–31.PubMedCrossRef

53.

Bhuriya R, Li S, Chen SC, McCullough PA, Bakris GL. Plasma parathyroid hormone level and prevalent cardiovascular disease in CKD stages 3 and 4: an analysis from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2009;53(4 Suppl 4):S3–10.PubMedCrossRef

54.

Hagström E, Hellman P, Larsson TE, Ingelsson E, Berglund L, Sundström J, Melhus H, Held C, Lind L, Michaëlsson K, Arnlöv J. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community. Circulation. 2009;119(21):2765–71.PubMedCrossRef

55.

Dusso AS, Brown AJ, Slatopolsky E. Vitamin D. Am J Physiol Renal Physiol. 2005;289(1):F8–28.PubMedCrossRef

56.

Hollis BW. Assessment and interpretation of circulating 25-hydroxyvitamin D and 1, 25-dihydroxyvitamin D in the clinical environment. Endocrinol Metab Clin North Am. 2010;39(2):271–86. table of contents.PubMedCrossRef

57.

Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the institute of medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53–8.PubMedCrossRef

58.

Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res. 2011;26(3):455–7.PubMedCrossRef

59.

Heaney RP. Assessing vitamin D status. Curr Opin Clin Nutr Metab Care. 2011;14(5):440–4.PubMedCrossRef

60.

Qazi RA, Martin KJ. Vitamin D in kidney disease: pathophysiology and the utility of treatment. Endocrinol Metab Clin North Am. 2010;39(2):355–63.PubMedCrossRef

61.

LaClair RE, Hellman RN, Karp SL, Kraus M, Ofner S, Li Q, Graves KL, Moe SM. Prevalence of calcidiol deficiency in CKD: a cross-sectional study across latitudes in the United States. Am J Kidney Dis. 2005;45(6):1026–33.PubMedCrossRef

62.

Leu M, Giovannucci E. Vitamin D: epidemiology of cardiovascular risks and events. Best Pract Res Clin Endocrinol Metab. 2011;25(4):633–46.PubMedCrossRef

63.

Mehrotra R, Kermah DA, Salusky IB, Wolf MS, Thadhani RI, Chiu YW, Martins D, Adler SG, Norris KC. Chronic kidney disease, hypovitaminosis D, and mortality in the United States. Kidney Int. 2009;76(9):977–83.PubMedCrossRef

64.

Melamed ML, Astor B, Michos ED, Hostetter TH, Powe NR, Muntner P. 25-hydroxyvitamin D levels, race, and the progression of kidney disease. J Am Soc Nephrol. 2009;20(12):2631–9.PubMedCrossRef

65.

Pilz S, Iodice S, Zittermann A, Grant WB, Gandini S. Vitamin D status and mortality risk in CKD: a meta-analysis of prospective studies. Am J Kidney Dis. 2011;58(3):374–82.PubMed

66.

Kandula P, Dobre M, Schold JD, Schreiber MJ Jr, Mehrotra R, Navaneethan SD. Vitamin D supplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials. Clin J Am Soc Nephrol. 2011;6(1):50–62.PubMedCrossRef

67.

Cunningham J, Zehnder D. New vitamin D analogs and changing therapeutic paradigms. Kidney Int. 2011;79(7):702–7.PubMedCrossRef

68.

Dusso AS, Tokumoto M. Defective renal maintenance of the vitamin D endocrine system impairs vitamin D renoprotection: a downward spiral in kidney disease. Kidney Int. 2011;79(7):715–29.PubMedCrossRef

69.

Wolf M, Shah A, Gutierrez O, Ankers E, Monroy M, Tamez H, Steele D, Chang Y, Camargo CA Jr, Tonelli M, Thadhani R. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 2007;72(8):1004–13.PubMedCrossRef

70.

John GB, Cheng CY, Kuro-o M. Role of Klotho in aging, phosphate metabolism, and CKD. Am J Kidney Dis. 2011;58(1):127–34.PubMedCrossRef

71.

Isakova T, Gutiérrez OM, Wolf M. A blueprint for randomized trials targeting phosphorus metabolism in chronic kidney disease. Kidney Int. 2009;76(7):705–16.PubMedCrossRef

72.

Shimada T, Urakawa I, Isakova T, Yamazaki Y, Epstein M, Wesseling-Perry K, Wolf M, Salusky IB, Jüppner H. Circulating fibroblast growth factor 23 in patients with end-stage renal disease treated by peritoneal dialysis is intact and biologically active. J Clin Endocrinol Metab. 2010;95(2):578–85.PubMedCrossRef

73.

Wolf M. Forging forward with 10 burning questions on FGF23 in kidney disease. J Am Soc Nephrol. 2010;21(9):1427–35.PubMedCrossRef

74.

Isakova T, Wahl P, Vargas GS, Gutiérrez OM, Scialla J, Xie H, Appleby D, Nessel L, Bellovich K, Chen J, Hamm L, Gadegbeku C, Horwitz E, Townsend RR, Anderson CA, Lash JP, Hsu CY, Leonard MB, Wolf M. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int. 2011;79(12):1370–8.PubMedCrossRef

75.

Nakai K, Komaba H, Fukagawa M. New insights into the role of fibroblast growth factor 23 in chronic kidney disease. J Nephrol. 2010;23(6):619–25.PubMed

76.

Gutiérrez OM, Mannstadt M, Isakova T, Rauh-Hain JA, Tamez H, Shah A, Smith K, Lee H, Thadhani R, Jüppner H, Wolf M. Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N Engl J Med. 2008;359(6):584–92.PubMedCrossRef

77.

Isakova T, Xie H, Yang W, Xie D, Anderson AH, Scialla J, Wahl P, Gutiérrez OM, Steigerwalt S, He J, Schwartz S, Lo J, Ojo A, Sondheimer J, Hsu CY, Lash J, Leonard M, Kusek JW, Feldman HI, Wolf M. Chronic renal insufficiency cohort (CRIC) study group. Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA. 2011;305(23):2432–9.PubMedCrossRef

78.

Parker BD, Schurgers LJ, Brandenburg VM, Christenson RH, Vermeer C, Ketteler M, Shlipak MG, Whooley MA, Ix JH. The associations of fibroblast growth factor 23 and uncarboxylated matrix Gla protein with mortality in coronary artery disease: the Heart and Soul Study. Ann Intern Med. 2010;152(10):640–8.PubMed

79.

Damasiewicz MJ, Toussaint ND, Polkinghorne KR. Fibroblast growth factor 23 in chronic kidney disease: new insights and clinical implications. Nephrology (Carlton). 2011;16(3):261–8.CrossRef

80.

Gal-Moscovici A, Sprague SM. Bone health in chronic kidney disease-mineral and bone disease. Adv Chronic Kidney Dis. 2007;14(1):27–36.PubMedCrossRef

81.

Cremers S, Garnero P. Biochemical markers of bone turnover in the clinical development of drugs for osteoporosis and metastatic bone disease: potential uses and pitfalls. Drugs. 2006;66(16):2031–58.PubMedCrossRef

82.

Whyte MP. Physiological role of alkaline phosphatase explored in hypophosphatasia. Ann NY Acad Sci. 2010;1192:190–200.PubMedCrossRef

83.

Ureña P, De Vernejoul MC. Circulating biochemical markers of bone remodeling in uremic patients. Kidney Int. 1999;55(6):2141–56.PubMedCrossRef

84.

Fahrleitner-Pammer A, Herberth J, Browning SR, Obermayer-Pietsch B, Wirnsberger G, Holzer H, Dobnig H, Malluche HH. Bone markers predict cardiovascular events in chronic kidney disease. J Bone Miner Res. 2008;23(11):1850–8.PubMedCrossRef

85.

Ureña P, Hruby M, Ferreira A, Ang KS, de Vernejoul MC. Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. J Am Soc Nephrol. 1996;7(3):506–12.PubMed

86.

Blayney MJ, Pisoni RL, Bragg-Gresham JL, Bommer J, Piera L, Saito A, Akiba T, Keen ML, Young EW, Port FK. High alkaline phosphatase levels in hemodialysis patients are associated with higher risk of hospitalization and death. Kidney Int. 2008;74(5):655–63.PubMedCrossRef

87.

Kovesdy CP, Ureche V, Lu JL, Kalantar-Zadeh K. Outcome predictability of serum alkaline phosphatase in men with pre-dialysis CKD. Nephrol Dial Transplant. 2010;25(9):3003–11.PubMedCrossRef

88.

89.

Damera S, Raphael KL, Baird BC, Cheung AK, Greene T, Beddhu S. Serum alkaline phosphatase levels associate with elevated serum C-reactive protein in chronic kidney disease. Kidney Int. 2011;79(2):228–33.PubMedCrossRef

90.

Drechsler C, Verduijn M, Pilz S, Krediet RT, Dekker FW, Wanner C, Ketteler M, Boeschoten EW, Brandenburg V. NECOSAD study group. Bone alkaline phosphatase and mortality in dialysis patients. Clin J Am Soc Nephrol. 2011;6(7):1752–9.PubMedCrossRef

91.

Razzaque MS. Osteocalcin: a pivotal mediator or an innocent bystander in energy metabolism? Nephrol Dial Transplant. 2011;26(1):42–5.PubMedCrossRef

92.

Delmas PD, Wilson DM, Mann KG, Riggs BL. Effect of renal function on plasma levels of bone Gla-protein. J Clin Endocrinol Metab. 1983;57(5):1028–30.PubMedCrossRef

93.

Morishita T, Nomura M, Hanaoka M, Saruta T, Matsuo T, Tsukamoto Y. A new assay method that detects only intact osteocalcin. Two-step non-invasive diagnosis to predict adynamic bone disease in haemodialysed patients. Nephrol Dial Transplant. 2000;15(5):659–67.PubMedCrossRef

94.

Coen G, Mazzaferro S, Ballanti P, Bonucci E, Bondatti F, Manni M, Pasquali M, Perruzza I, Sardella D, Spurio A. Procollagen type I C-terminal extension peptide in predialysis chronic renal failure. Am J Nephrol. 1992;12(4):246–51.PubMedCrossRef

95.

Hamdy NA, Risteli J, Risteli L, Harris S, Beneton MN, Brown CB, Kanis JA. Serum type I procollagen peptide: a non-invasive index of bone formation in patients on haemodialysis? Nephrol Dial Transplant. 1994;9(5):511–6.PubMed

96.

Ureña P, Ferreira A, Kung VT, Morieux C, Simon P, Ang KS, Souberbielle JC, Segre GV, Drüeke TB, De Vernejoul MC. Serum pyridinoline as a specific marker of collagen breakdown and bone metabolism in hemodialysis patients. J Bone Miner Res. 1995;10(6):932–9.PubMedCrossRef

97.

Ueda M, Inaba M, Okuno S, Nagasue K, Kitatani K, Ishimura E, Shimizu M, Miki T, Kim M, Nishizawa Y. Clinical usefulness of the serum N-terminal propeptide of type I collagen as a marker of bone formation in hemodialysis patients. Am J Kidney Dis. 2002;40(4):802–9.PubMedCrossRef

98.

Janckila AJ, Yam LT. Biology and clinical significance of tartrate-resistant acid phosphatases: new perspectives on an old enzyme. Calcif Tissue Int. 2009;85(6):465–83.PubMedCrossRef

99.

Halleen JM, Alatalo SL, Suominen H, Cheng S, Janckila AJ, Väänänen HK. Tartrate-resistant acid phosphatase 5b: a novel serum marker of bone resorption. J Bone Miner Res. 2000;15(7):1337–45.PubMedCrossRef

100.

Ohashi T, Igarashi Y, Mochizuki Y, Miura T, Inaba N, Katayama K, Tomonaga T, Nomura F. Development of a novel fragments absorbed immunocapture enzyme assay system for tartrate-resistant acid phosphatase 5b. Clin Chim Acta. 2007;376(1–2):205–12.PubMedCrossRef

101.

Chu P, Chao TY, Lin YF, Janckila AJ, Yam LT. Correlation between histomorphometric parameters of bone resorption and serum type 5b tartrate-resistant acid phosphatase in uremic patients on maintenance hemodialysis. Am J Kidney Dis. 2003;41(5):1052–9.PubMedCrossRef

102.

Lehmann G, Ott U, Kaemmerer D, Schuetze J, Wolf G. Bone histomorphometry and biochemical markers of bone turnover in patients with chronic kidney disease Stages 3–5. Clin Nephrol. 2008;70(4):296–305.PubMed

103.

Shidara K, Inaba M, Okuno S, Yamada S, Kumeda Y, Imanishi Y, Yamakawa T, Ishimura E, Nishizawa Y. Serum levels of TRAP5b, a new bone resorption marker unaffected by renal dysfunction, as a useful marker of cortical bone loss in hemodialysis patients. Calcif Tissue Int. 2008;82(4):278–87.PubMedCrossRef

104.

Ureña P, Bernard-Poenaru O, Ostertag A, Baudoin C, Cohen-Solal M, Cantor T, de Vernejoul MC. Bone mineral density, biochemical markers and skeletal fractures in haemodialysis patients. Nephrol Dial Transplant. 2003;18(11):2325–31.PubMedCrossRef

105.

Maeno Y, Inaba M, Okuno S, Yamakawa T, Ishimura E, Nishizawa Y. Serum concentrations of cross-linked N-telopeptides of type I collagen: new marker for bone resorption in hemodialysis patients. Clin Chem. 2005;51(12):2312–7.PubMedCrossRef

Title: Biochemical Abnormalities in Chronic Kidney Disease–Mineral Bone Disease
Author: Lavinia A. Negrea
Publication date: 01-09-2012
Publisher: Springer-Verlag
Published in: Clinical & Translational Metabolism / Issue 3/2012
Print ISSN: 1534-8644
Electronic ISSN: 2948-2445
DOI: https://doi.org/10.1007/s12018-011-9122-6

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Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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Other articles of this Issue 3/2012

Medical and Surgical Management (Including Diet)

Chronic Kidney Disease–Mineral Bone Disorder: New Understandings of an Old Disease

Specific Bone and Mineral Disorders in Patients with Chronic Kidney Disease

Chronic Kidney Disease-Mineral Bone Disorder: Definitions and Rationale for a Systemic Disorder

Bone Mineral Density in Chronic Kidney Disease Use and Misuse

Pathophysiology of CKD-MBD

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage