Correlation of the severity of chronic kidney disease with serum inflammation, osteoporosis and vitamin D deficiency

Liu, Cewen; Li, Hui

doi:10.3892/etm.2018.6916

Cited by 14 publications

(14 citation statements)

References 21 publications

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“…Nevertheless, the severity of CKD is strongly associated with inflammatory mediators and insufficiency of vitamin D. With the progression of CKD, more inflammatory factors are released, phosphate levels increase, and calcium levels decrease. Increased phosphate level activates the NF-κB pathway and leads to an increased level of tumor necrosis factor-alpha (TNF-α), thus causing overactivation of the inflammatory system [23].…”

Section: Methodsmentioning

confidence: 99%

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Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Tasnim¹,

Dutta

Nayeem

et al. 2021

Cureus

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Nowadays, chronic kidney disease (CKD) and osteoporosis have become crucial health-related issues globally. CKD-induced osteoporosis is a systemic disease characterized by the disruption of mineral, hormone, and vitamin homeostasis that elevates the likelihood of fracture. Here, we review recent studies on the association of CKD and osteoporosis. In particular, we focus on the pathogenesis of CKD-associated osteoporosis, including the homeostasis and pathways of several components such as parathyroid hormone, calcium, phosphate, vitamin D, fibroblast growth factor, and klotho, as well as abnormal bone mineralization, remodeling, and turnover. In addition, we explore the diagnostic tools and possible therapeutic approaches for the management and prevention of CKD-associated osteoporosis. Patients with CKD show higher osteoporosis prevalence, greater fracture rate, increased morbidity and mortality, and an elevated occurrence of hip fracture. We also rule out that increased severity of CKD is related to a more severe condition of osteoporosis. Furthermore, supplements such as calcium and vitamin D as well as lifestyle modifications such as exercise and cessation of smoking and alcohol help in fracture prevention. However, new approaches and advancements in treatment are needed to reduce the fracture risk in patients with CKD. Therefore, further collaborative multidisciplinary research is needed in this regard.

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Section: Methodsmentioning

confidence: 99%

“…PTH is a crucial representative biomarker for bone fragility [23]. It usually remains normal until GFR is 45 mL/minute/1.73 m 2 , and its elevation reduces GFR [12,24,25].…”

Section: Methodsmentioning

confidence: 99%

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Tasnim¹,

Dutta

Nayeem

et al. 2021

Cureus

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show abstract

“…A vitamin D deficiency is a common condition associated with kidney disease. Many clinical studies have highlighted how a vitamin D deficiency is an important risk factor for CKD patients [36, 37].…”

Section: Resultsmentioning

confidence: 99%

Inflammation-Related Patterns in the Clinical Staging and Severity Assessment of Chronic Kidney Disease

et al. 2019

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Chronic kidney disease (CKD) is an irreversible loss of kidney function, and it represents a major global public health burden due to both its prevalence and its continuously increasing incidence. Mineral bone disorders (MBDs) constitute a hallmark of CKD, and alongside cardiovascular complications, they underlie a poor prognosis for these patients. Thus, our study focused on novel CKD biomarker patterns and their impact on the clinical staging of the disease. As a first testing approach, the relative expression levels of 105 proteins were assessed by the Proteome Profiler Cytokine Array Kit for pooled CKD stage 2–4 serum samples to establish an overall view regarding the proteins involved in CKD pathogenesis. Among the molecules that displayed significant dysregulation in the CKD stages, we further explored the involvement of Dickkopf-related protein 1 (Dkk-1), a recognised inhibitor of the Wnt signalling pathway, and its crosstalk with 1,25OH2D3 (calcitriol) as new players in renal bone and vascular disease. The serum levels of these two molecules were quantified by an ELISA (76 samples), and the results reveal decreasing circulating levels of Dkk-1 and calcitriol in advanced CKD stages, with their circulating expression showing a downward trend as the CKD develops. In the next step, we analysed the inflammation and MBD biomarkers' expression in CKD (by xMAP array). Our results show that the molecules involved in orchestrating the inflammatory response, interleukin-6 (IL-6) and tumour necrosis factor alpha (TNFα), as well as the mineral biomarkers osteoprotegerin (OPG), osteocalcin (OC), osteopontin (OPN), and fibroblast growth factor 23 (FGF-23), correlate with Dkk-1 and calcitriol, raising the possibility of them being potential useful CKD biomarkers. These results reveal the impact of different biomarker patterns in CKD staging and severity, thus opening up novel approaches to be explored in CKD clinical management.

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“…53 The changes place both genders at risk and have been postulated to lead to severe adverse consequences such as osteoporosis, breast, colon and prostate cancers and hypertension. 53 Chronic kidney disease equally places both genders at increased risk of osteoporosis and increased requirement for vitamin D. 54 Clinical trials have demonstrated that 800 IU (20 μg) per day of vitamin D in combination with 1 200 mg calcium reduced the risk of fractures due to falls in the institutionalised elderly, who are not ambulatory or exercising, and that single doses of 100 000 IU orally every fourth month, without calcium, reduces fracture risk in mobile community-dwelling individuals over 65 years of age. 53 Another study suggested a three-year combined programme of denosumab (a monoclonal antibody) and vitamin D supplementation for the treatment of osteoporosis and rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 99%

Prescribing patterns of vitamin D and analogues in a private healthcare patient population in South Africa

Morris-Paxton

Truter

2020

South African Journal of Clinical Nutrition

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Numerous studies show the benefits of vitamin D: in the prevention of bone disease, supporting the immune system and the prevention and mitigation of cancer. Until recently, supplementation has been deemed unnecessary. Nonetheless, in the light of emerging evidence, some practitioners are adding vitamin D and its analogues (Anatomic Therapeutic Chemical (ATC) classification code A11CC) to their prescriptions. Therefore, the aim was to determine the medical insurance prescribing patterns of vitamin D in South Africa. Methods: A retrospective, cross-sectional drug utilisation study was conducted on a South African medical insurance administrator database for 2018. Products in ATC subgroup A11CC (vitamin D and analogues) were extracted and analysed. Results: A total of 302 patients received 1 164 prescriptions for a vitamin D or analogue product during 2018. The average age of patients was 47.14 (SD = 24.03) years, and the majority were female (58.28%). Very young patients and middle-aged patients received most of the prescriptions. Ergocalciferol (A11CC01) was the most frequently prescribed (59.79%), followed by alfacalcidol (A11CC), colecalciferol (A11CC05) and calcitriol (A11CC04). Ergocalciferol 50 000 IU tablets comprised the most frequently prescribed trade name product (59.45%), followed by alfacalcidol capsules (21.31%). Conclusion: Vitamin D was used across the age range. Vitamin D supplementation was primarily prescribed in the very young and older age groups, suggesting their need for additional supplementation. As the cost of additional supplements is relatively small compared with the treatment of deficiency disorders, vitamin D supplementation could have broad and positive effects on long-term health for very little outlay.

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Correlation of the severity of chronic kidney disease with serum inflammation, osteoporosis and vitamin D deficiency

Cited by 14 publications

References 21 publications

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Inflammation-Related Patterns in the Clinical Staging and Severity Assessment of Chronic Kidney Disease

Prescribing patterns of vitamin D and analogues in a private healthcare patient population in South Africa

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