title: Uremic osteoporosis.
abstract: Abnormalities in bone turnover, mineralization, and volume represent one of the three components of chronic kidney disease-related mineral and bone disorder (CKD-MBD). The risk of hip fracture is considerably high, while the risk of spinal compression fracture may not be more elevated among CKD patients than in general population. The relationship between bone fracture and bone mineral density in CKD patients is more complex than in those without kidney disease. An increase in the rate of falls has been reported to be a major cause of high hip fracture risk among CKD patients; however, it certainly is not the only underlying mechanism. Abnormal parathyroid function is not likely to be a major cause of hip fracture among CKD patients. In experimental CKD animals, mechanical elasticity properties of long bones showed an inverse correlation with kidney function. The deterioration of bone elasticity showed a significant correlation with bone biochemical changes. Of note, administration of the oral absorbent AST-120 was capable of preventing both changes. These findings suggest that uremic toxins cause a deterioration of bone material properties, and changes in material properties disturb bone elasticity. This disease concept cannot be considered to be a direct consequence of CKD-MBD. We therefore would like to call it 'uremic osteoporosis'. This entity may be a major cause of increased hip fracture risk among CKD patients.
authors.affiliation: Division of Blood Purification Therapy, Niigata University Medical and Dental Hospital , Niigata, Japan.
authors.forename: Junichiro J
authors.initials: JJ
authors.lastname: Kazama
authors.affiliation: Department of Health Sciences, Oita University of Nursing and Health Sciences , Oita, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Iwasaki
authors.affiliation: Division of Nephrology and Metabolism, Tokai University School of Medicine , Kanagawa, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
keywords: bone elastic mechanical properties; hip fracture; osteoporosis; uremic toxin