title: Inflammation and the bone-vascular axis in end-stage renal disease.
abstract: Bone loss and vascular calcification coincide in patients with end-stage renal disease, similar as to what is observed in the general population. In the present bone biopsy study, we provide further evidence that (micro-)inflammation may represent a common soil for both diseases.
  
  
  BACKGROUND
  Vascular calcification is a common complication of end-stage renal disease (ESRD) and is predictive of subsequent cardiovascular disease and mortality. Mounting evidence linking bone disorders with vascular calcification has contributed to the development of the concept of the bone-vascular axis. Inflammation is involved in the pathogenesis of both disorders. The aim of the present study was to evaluate the relationship between aortic calcification, inflammation, and bone histomorphometry in patients with ESRD.
  
  
  METHODS
  Parameters of inflammation and mineral metabolism were assessed in 81 ESRD patients (55 ± 13 year, 68 % male) referred for renal transplantation. Static bone histomorphometry parameters were determined on transiliac bone biopsies performed during the transplant procedure. Aortic calcification was quantified on lateral lumbar X-rays using the Kauppila method.
  
  
  RESULTS
  Aortic calcification, low bone turnover, and low bone area were observed in 53, 37, and 21 % of patients respectively. Inflammatory markers were found to be independently associated with aortic calcification (hsIL-6) and low bone area (TNF-α). Low bone area associated with aortic calcification, independent of age, diabetes, and inflammation.
  
  
  CONCLUSIONS
  Low bone area and inflammation associates with aortic calcification, independent of each other and traditional risk factors. Our data emphasize the role of (micro-)inflammation in the bone-vascular axis in CKD.
authors: Department of Nephrology, Catholic University Leuven, KU Leuven, Belgium.
authors: L
authors: L
authors: Viaene
authors: Laboratory of Pathophysiology, University of Antwerp, Antwerp, Belgium.
authors: G J
authors: GJ
authors: Behets
authors: Department of Radiology, University Hospitals Leuven, KU Leuven, Belgium.
authors: S
authors: S
authors: Heye
authors: Department of Nephrology, Catholic University Leuven, KU Leuven, Belgium.
authors: K
authors: K
authors: Claes
authors: Department of Abdominal Transplant Surgery, University Hospitals Leuven, KU Leuven, Belgium.
authors: D
authors: D
authors: Monbaliu
authors: Department of Abdominal Transplant Surgery, University Hospitals Leuven, KU Leuven, Belgium.
authors: J
authors: J
authors: Pirenne
authors: Laboratory of Pathophysiology, University of Antwerp, Antwerp, Belgium.
authors: P C
authors: PC
authors: D'Haese
authors: Department of Nephrology, Catholic University Leuven, KU Leuven, Belgium. Pieter.Evenepoel@uzleuven.ac.be.|Dienst nefrologie, Universitair Ziekenhuis Gasthuisberg, Herestraat 49, B-3000, Leuven, Belgium. Pieter.Evenepoel@uzleuven.ac.be.
authors: P
authors: P
authors: Evenepoel
mesh_terms: D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000209:etiology*; D001706:Biopsy; D016723:Bone Remodeling / Q000502:physiology; D005260:Female; D006801:Humans; D007085:Ilium / Q000473:pathology; D007249:Inflammation / Q000150:complications* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D061205:Vascular Calcification / Q000209:etiology*
chemical_list: D018836:Inflammation Mediators
keywords: Aortic calcification; Bone histomorphometry; End-stage renal disease