title: The effect of naturally occurring chronic kidney disease on the micro-structural and mechanical properties of bone.
abstract: Chronic kidney disease (CKD) is a growing public health concern worldwide, and is associated with marked increase of bone fragility. Previous studies assessing the effect of CKD on bone quality were based on biopsies from human patients or on laboratory animal models. Such studies provide information of limited relevance due to the small size of the samples (biopsies) or the non-physiologic CKD syndrome studied (rodent models with artificially induced CKD). Furthermore, the type, architecture, structure and biology of the bone of rodents are remarkably different from human bones; therefore similar clinicopathologic circumstances may affect their bones differently. We describe the effects of naturally occurring CKD with features resembling human CKD on the skeleton of cats, whose bone biology, structure and composition are remarkably similar to those of humans. We show that CKD causes significant increase of resorption cavity density compared with healthy controls, as well as significantly lower cortical mineral density, cortical cross-sectional area and cortical cross-sectional thickness. Young's modulus, yield stress, and ultimate stress of the cortical bone material were all significantly decreased in the skeleton of CKD cats. Cancellous bone was also affected, having significantly lower trabecular thickness and bone volume over total volume in CKD cats compared with controls. This study shows that naturally occurring CKD has deleterious effects on bone quality and strength. Since many similarities exist between human and feline CKD patients, including the clinicopathologic features of the syndrome and bone microarchitecture and biology, these results contribute to better understanding of bone abnormalities associated with CKD.
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Shipov
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Segev
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Hagar
authors.initials: H
authors.lastname: Meltzer
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Milrad
authors.affiliation: Department of Veterinary Resources, Weizmann Institute, Rehovot, Israel.
authors.forename: Ori
authors.initials: O
authors.lastname: Brenner
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Ayelet
authors.initials: A
authors.lastname: Atkins
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Shahar
mesh_terms: D000818:Animals; D015519:Bone Density; D001847:Bone Diseases / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D001842:Bone and Bones / Q000378:metabolism / Q000473:pathology*; D016022:Case-Control Studies; D002415:Cats; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D008297:Male; D055595:Mechanical Phenomena; D009929:Organ Size; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000378:metabolism; D055114:X-Ray Microtomography