Update on the role of bone biopsy in the management of patients with CKD–MBD

Patients with chronic kidney disease (CKD) are at increased risk of fractures. The fracture risk steadily increases along with the progression of renal disease to become several-fold higher in end-stage renal disease (ESRD) patients as compared to age and sex-matched controls. Renal osteodystrophy (...

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Bibliographic Details
Published in:Journal of nephrology 2017-10, Vol.30 (5), p.645-652
Main Authors: Evenepoel, P., Behets, G. J. S., Laurent, M. R., D’Haese, P. C.
Format: Article
Language:English
Subjects:
Biopsy - methods
Bone and Bones - pathology
Bone Remodeling
Calcification, Physiologic
Chronic Kidney Disease-Mineral and Bone Disorder - diagnosis
Chronic Kidney Disease-Mineral and Bone Disorder - epidemiology
Chronic Kidney Disease-Mineral and Bone Disorder - pathology
Chronic Kidney Disease-Mineral and Bone Disorder - physiopathology
Humans
Medicine
Medicine & Public Health
Nephrology
Patient Selection
Renal Insufficiency, Chronic - complications
Review
Urology
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Summary:Patients with chronic kidney disease (CKD) are at increased risk of fractures. The fracture risk steadily increases along with the progression of renal disease to become several-fold higher in end-stage renal disease (ESRD) patients as compared to age and sex-matched controls. Renal osteodystrophy (ROD) is a heterogeneous group of metabolic bone diseases complicating progressive chronic kidney disease. Bone biomarkers and bone imaging techniques may help to assess bone health and predict fractures in CKD, but do have important inherent limitations. The gold standard for the diagnosis and specific classification of renal osteodystrophy (ROD) remains the (quantitative) histomorphometric analysis of the bone biopsy. By informing on bone turnover and mineralization, a bone biopsy may help guide prevention and treatment of ROD and its consequences. This review aims to present an update on epidemiological and procedural aspects, clinical indications, and histomorphometric analysis of bone biopsies and to define the role of bone biopsy in current CKD–MBD care.
ISSN:1121-8428
1724-6059
DOI:10.1007/s40620-017-0424-8