Review article: Bone biopsy in chronic kidney disease: patient level end-point or just another test?
The reduction of renal function in chronic kidney disease leads to disturbed calcium and phosphorus metabolism, impaired action of calcitriol, increased parathyroid hormone, FGF-23 levels and ultimately bone disorders. These disturbances have been traditionally termed renal osteodystrophy, which evaluation and diagnosis require a bone biopsy. In the last four decades, researchers from different countries have developed new techniques and have introduced concepts that allowed the development of bone histomorphometry, considered the key tool to study bone metabolism, remodelling and structure. In this review we focus on the relevance of bone biopsy and its respective histomorphometric analysis to help nephrologists to evaluate patients with chronic kidney disease.
Jorgetti
Vanda
V
Nephrology Division, Hospital das Clínicas, Faculdade de Medicina, São Paulo University, São Paulo, Brazil. vandajor@usp.br
D001706:Biopsy; D001842:Bone and Bones / Q000378:metabolism / Q000473:pathology*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000378:metabolism / Q000473:pathology*; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000378:metabolism / Q000473:pathology*