Bone density, microarchitecture, and material strength in chronic kidney disease patients at the time of kidney transplantation

AbstractSummaryBone health is assessed by bone mineral density (BMD). Other techniques such as trabecular bone score and microindentation could improve the risk of fracture ’s estimation. Our chronic kidney disease (CKD) patients presented worse bone health (density, microarchitecture, mechanical properties) than controls. More than BMD should be done to evaluate patients at risk of fracture.IntroductionBMD measured by dual-energy X-ray absorptiometry (DXA) is used to assess bone health in end-stage renal disease (ESRD) patients. Recently, trabecular bone score (TBS) and microindentation that can measure microarchitectural and mechanical properties of bone have demonstrated better correlation with fractures than DXA in different populations. We aimed to characterize bone health (BMD, TBS, and strength) and calcium/phosphate metabolism in a cohort of 53 ESRD patients undergoing kidney transplantation (KT) and 94 controls with normal renal function.MethodsLaboratory workout, lumbar spine/hip BMD measurements (using DXA), lumbar spine TBS, and bone strength were carried out. The latter was assessed with an impact microindentation device, standardized as percentage of a reference value, and expressed as bone material strength index (BMSi) units. Multivariable linear regression was used to study differences between cases and controls adjusted by age, gender, and body mass index.ResultsAmong cases, serum calcium was 9.6  ± 0.7 mg/dl, phosphorus 4.4 ...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research

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Authors: Ponticelli C, Arnaboldi L, Moroni G, Corsini A Abstract Introduction: Lipid disorders are frequent after kidney transplantation (KT) and KT recipients are considered at high- or very-high cardiovascular risk. Among many concurring factors, a major role is played by immunosuppressants.Areas covered: General measures to manage lipid disorders first include physical activity and diet counseling. Modulating the doses of immunosuppressants also improves dyslipidemia. When lipid-lowering drugs are necessary to control elevated plasma cholesterol and/or triglycerides, statins are the cornerstone for managing hype...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): F. Matsunaga, N. Azar
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): Y. Wang, K. Schachtschneider, Y. Huang, R. Gaba, P. Nguyen, P. Yen, M. Sverdlov, G. Guzman, R. Lokken
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): V. Acharya, A. Swersky, B. Fox, S. Tummala, Z. Miller, S. Venkat, I. Kably, P. Mohan
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
AJ Gunn, M.D. graduated magna cum laude from Brigham Young University in Provo, UT, earning a BS in exercise physiology with a minor in sociology. He then returned home to South Dakota to attend medical school at the University of South Dakota. During medical school, he participated in the competitive Howard Hughes Medical Institute – National Institutes of Health Research Scholars Program and was awarded the Donald L. Alcott, M.D. Award for Clinical Promise. He graduated summa cum laude in 2009. He completed his diagnostic radiology residency at the Massachusetts General Hospital of Harvard Medical School in Boston,...
Source: radRounds - Category: Radiology Authors: Source Type: blogs
Publication date: Available online 20 February 2020Source: IDCasesAuthor(s): Heather L. Clark, Hugo E. Valencia, Jennifer J. Findeis-Hosey, Steve N. GeorasAbstractAspergillus molds are ubiquitous environmental molds that can cause devastating invasive infections in immunocompromised patients. These infections often go unrecognized in critically ill patients. This case describes a 68 year-old female resident of a long-term nursing facility with history of dementia, nonalcoholic fatty liver disease with cirrhosis, chronic kidney disease stage III and insulin-dependent type 2 diabetes who presented with vomiting, diarrhea and...
Source: IDCases - Category: Infectious Diseases Source Type: research
Publication date: Available online 20 February 2020Source: Journal of Evidence Based Dental PracticeAuthor(s): Yixuan Wang, Fang Hua, Han Jiang
Source: Journal of Evidence Based Dental Practice - Category: Dentistry Source Type: research
We report on nanoptodes that can be used both in alkaline and in acidic pH range inaccessible for classical systems using pH sensitive dyes as transducers. The proposed sensors offer 6 orders of magnitude broad, linear dependence of emission intensity on logarithm of analyte (K+ or Ca2+) concentration, in turn on mode. However, the slopes of calibration plots are to some extent dependent on solution pH and oxygen presence/absence. It is shown that this effect is resulting from changes of solution redox potential maintained mainly by dissolved oxygen. The solution redox potential affects the oxidation state of the polymer a...
Source: Talanta - Category: Chemistry Authors: Tags: Talanta Source Type: research
Authors: Loutradis C, Sarafidis P Abstract Introduction: Hypertension is the most common co-morbidity in patients with chronic kidney disease (CKD), with prevalence gradually increasing across CKD Stages to the extent that about 90% of end-stage renal disease (ESRD) patients are hypertensives. Several factors contribute to blood pressure (BP) elevation and guide the therapeutic interventions that should be employed in these patients.Areas covered: This review summarizes the existing data for the management of hypertension, regarding optimal BP targets and the use of major antihypertensive classes in patients with C...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
We describe a 64-year-old man with severe bone loss and persistent secondary hyperparathyroidism (SHPT) after renal transplantation, whose condition failed to respond to conventional pharmacologic or surgical interventions. He underwent parathyroidectomy with left forearm autograft of crushed tiny parathyroid gland (PTG) particles. However, the autografted PTGs became swollen and caused persistent SHPT in spite of two additional parathyroidectomies of the left forearm. A single subcutaneous administration of DMAb induced hypocalcemia, which was corrected by calcium supplementation and high-dose calcitriol. Eventually, comb...
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
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