Rosilene Motta Elias1,2, Maria Aparecida Dalboni1, Ana Carolina E Coelho3, Rosa M A Moysés4,5. 1. Universidade Nove de Julho, UNINOVE, Rua Iperoig, 690 ap 121, São Paulo, SP, 05016-000, Brazil. 2. Nephrology Division, HCFCMUSP, Universidade de São Paulo, São Paulo, Brazil. 3. Nephrology Division, Universidade Estadual Paulista, UNESP, São Paulo, Brazil. 4. Universidade Nove de Julho, UNINOVE, Rua Iperoig, 690 ap 121, São Paulo, SP, 05016-000, Brazil. rosa.moyses@uol.com.br. 5. Nephrology Division, HCFCMUSP, Universidade de São Paulo, São Paulo, Brazil. rosa.moyses@uol.com.br.
Abstract
PURPOSE OF REVIEW: Although we have seen tremendous advances in the comprehension of CKD-MBD pathophysiology during the last few years, this was not accompanied by a significant change in mortality rate and quality of life. This review will address the traditional and updated pathophysiology of CKD-MBD along with the therapeutic limitations that affect CKD-MBD and proposed alternative treatment targets. RECENT FINDINGS: An innovative concept brings the osteocyte to the center of CKD-MBD pathophysiology, in contrast to the traditional view of the skeleton as a target organ for disturbances in calcium, phosphate, parathyroid hormone, and vitamin D. Osteocytes, through the synthesis of FGF-23, sclerostin, among others, are able to interact with other organs, making bone an endocrine organ. Thus, osteocyte dysregulation might be an early event during the course of CKD. This review will revisit general concepts on the pathophysiology of CKD-MBD and discuss new perspectives for its treatment.
PURPOSE OF REVIEW: Although we have seen tremendous advances in the comprehension of CKD-MBD pathophysiology during the last few years, this was not accompanied by a significant change in mortality rate and quality of life. This review will address the traditional and updated pathophysiology of CKD-MBD along with the therapeutic limitations that affect CKD-MBD and proposed alternative treatment targets. RECENT FINDINGS: An innovative concept brings the osteocyte to the center of CKD-MBD pathophysiology, in contrast to the traditional view of the skeleton as a target organ for disturbances in calcium, phosphate, parathyroid hormone, and vitamin D. Osteocytes, through the synthesis of FGF-23, sclerostin, among others, are able to interact with other organs, making bone an endocrine organ. Thus, osteocyte dysregulation might be an early event during the course of CKD. This review will revisit general concepts on the pathophysiology of CKD-MBD and discuss new perspectives for its treatment.
Authors: Rodrigo P Pedrosa; Luciano F Drager; Carolina C Gonzaga; Marcio G Sousa; Lílian K G de Paula; Aline C S Amaro; Celso Amodeo; Luiz A Bortolotto; Eduardo M Krieger; T Douglas Bradley; Geraldo Lorenzi-Filho Journal: Hypertension Date: 2011-10-03 Impact factor: 10.190
Authors: Yves Sabbagh; Fabiana Giorgeti Graciolli; Stephen O'Brien; Wen Tang; Luciene Machado dos Reis; Susan Ryan; Lucy Phillips; Joseph Boulanger; Wenping Song; Christina Bracken; Shiguang Liu; Steven Ledbetter; Paul Dechow; Maria Eugenia F Canziani; Aluizio B Carvalho; Vanda Jorgetti; Rosa M A Moyses; Susan C Schiavi Journal: J Bone Miner Res Date: 2012-08 Impact factor: 6.741
Authors: Melita M Dvorak; Cyrille De Joussineau; D Howard Carter; Trairak Pisitkun; Mark A Knepper; Gerardo Gamba; Paul J Kemp; Daniela Riccardi Journal: J Am Soc Nephrol Date: 2007-07-26 Impact factor: 10.121
Authors: Abdullah N Ben-awadh; Jesus Delgado-Calle; Xiaolin Tu; Kali Kuhlenschmidt; Matthew R Allen; Lilian I Plotkin; Teresita Bellido Journal: Endocrinology Date: 2014-05-30 Impact factor: 4.736
Authors: Cristian Rodelo-Haad; Rafael Santamaria; Juan R Muñoz-Castañeda; M Victoria Pendón-Ruiz de Mier; Alejandro Martin-Malo; Mariano Rodriguez Journal: Toxins (Basel) Date: 2019-03-22 Impact factor: 4.546
Authors: Maria L Mace; Eva Gravesen; Anders Nordholm; Soeren Egstrand; Marya Morevati; Carsten Nielsen; Andreas Kjaer; Geert Behets; Patrick D'Haese; Klaus Olgaard; Ewa Lewin Journal: J Bone Miner Res Date: 2020-12-10 Impact factor: 6.741
Authors: Shirley Ferraz Crispilho; Eduardo Jorge Duque; Kalyanna Soares Bezerra; Rosa Maria R Pereira; Vanda Jorgetti; Rosilene M Elias; Rosa M A Moysés Journal: J Bras Nefrol Date: 2021 Apr-Jun