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Bone fragility as a possible complication of chronic kidney disease in early stages

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Resumo:Introduction: Chronic Kidney Disease (CKD) is a worldwide health problem and disturbances in mineral metabolism are common complications of the disease, contributing to bone fragility. Along with CKD, Osteoporosis is also a very common disorder of aging populations. Moreover, with the normal aging process on the bone, there is an acceleration of the deterioration, prematurely diminution bone quality and strength and increased early susceptibility to fractures. Consequently, one of the major complications of CKD, especially in elderly patients, is also the increased risk of fragility fractures, which is well demonstrated in patients with end-stage renal disease (ESRD). Objective: the aim is to evaluate whether CKD, in stages before ESRD, is associated with bone fragility. Methods and Patients: We studied patients admitted for total hip replacement surgery. The patients who gave their informed consent, were asked for clinical data and blood samples. Blood biomechanical studies were performed and a bone cylinder was drilled from their femoral epiphyses. Glomerular filtration rate (GFR) was estimated using CKD-EPI equation. Results: We included 351 patients, divided in two groups: those with Osteoporosis (OP) and those with Osteoarthritis (OA) (control group). In the study group mean age was 78.98 ± 8.72, 80% were female. No association was found between existence of previous fragility fractures and estimated GFR (eGFR) or mechanical tests measures and eGFR both in OP and OA group (p> 0.05). Also, association between bone turnover markers (BTM) and eGFR was inexistence in the OP group. The biomarkers beta-crosslaps (CTX) and amino-terminal propeptides of type I procollagen (P1NP) showed an association with eGFR (p<0.05) in the OA group. Although we can’t state an association between CKD early stages and bone fragility with our results, and specifically with the indicators we used, further assessments should be done on the topic.
Autores principais:Maia, Maria de Araújo Barros
Assunto:Insuficiência renal crónica Fragilidade óssea Reumatologia
Ano:2014
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso restrito
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa

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