Osteoprotegerin and bone mineral metabolism in renal failure.
OBJECTIVE
This review focuses on the impact of a recent breakthrough in bone cell biology for understanding the pathophysiology of bone/vascular abnormalities associated with uraemia.


RESULTS
Osteoprotegerin is a humoral osteoclastogenesis/osteoclast activation inhibitory factor, which belongs to the TNF-alpha receptor superfamily. Serum osteoprotegerin levels are elevated along with the deterioration of the glomerular filtration rate. The circulating osteoprotegerin molecules were likely to preserve the activity of osteoclastogenesis inhibition, and the levels in many dialysis patients were high enough to inhibit osteoclastogenesis. The higher serum osteoprotegerin levels were related to the development of vascular calcification.


CONCLUSIONS
Osteoprotegerin is a potential uraemic toxin that increases the skeletal resistance to PTH. However, the roles of increased circulating osteoprotegerin on bone and/or vascular abnormalities in uraemia remain to be clarified.
Kazama
Junichiro J
JJ
Division of Intensive Care Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan. jjkaz@med.niigata-u.ac.jp
D015519:Bone Density / Q000502:physiology*; D001847:Bone Diseases / Q000378:metabolism* / Q000503:physiopathology; D001842:Bone and Bones / Q000378:metabolism / Q000503:physiopathology; D006023:Glycoproteins / Q000502:physiology*; D006801:Humans; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear / Q000502:physiology*; D018124:Receptors, Tumor Necrosis Factor; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology; D014511:Uremia / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D014652:Vascular Diseases / Q000378:metabolism* / Q000503:physiopathology
D006023:Glycoproteins; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C506030:TNFRSF11B protein, human