Shipov Anna, Segev Gilad, Meltzer Hagar, Milrad Moran, Brenner Ori, Atkins Ayelet, Shahar Ron
Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
Department of Veterinary Resources, Weizmann Institute, Rehovot, Israel.
PLoS One. 2014 Oct 15;9(10):e110057. doi: 10.1371/journal.pone.0110057. eCollection 2014.
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.
慢性肾脏病（CKD）是全球范围内日益受到关注的公共卫生问题，并且与骨脆性的显著增加相关。以往评估CKD对骨质量影响的研究是基于人类患者的活检或实验动物模型。由于样本（活检）规模较小或所研究的非生理性CKD综合征（人工诱导CKD的啮齿动物模型），此类研究提供的信息相关性有限。此外，啮齿动物骨骼的类型、结构、构造及生物学特性与人类骨骼显著不同；因此，相似的临床病理情况可能对它们的骨骼产生不同影响。我们描述了具有类似人类CKD特征的自然发生的CKD对猫骨骼的影响，猫的骨骼生物学、结构和组成与人类的显著相似。我们发现，与健康对照相比，CKD导致吸收腔密度显著增加，同时皮质骨矿物质密度、皮质横截面积和皮质横截面厚度显著降低。CKD猫骨骼中皮质骨材料的杨氏模量、屈服应力和极限应力均显著降低。松质骨也受到影响，与对照组相比，CKD猫的小梁厚度和骨体积占总体积的比例显著降低。这项研究表明，自然发生的CKD对骨质量和强度具有有害影响。由于人类和猫CKD患者之间存在许多相似之处，包括该综合征的临床病理特征以及骨微结构和生物学特性，这些结果有助于更好地理解与CKD相关的骨异常情况。
