McNerny Erin M B, Nickolas Thomas L
Indiana University School of Medicine, Indianapolis, IN, USA.
Division of Nephrology, Department of Medicine, Columbia University Medical Center, 622 West 168th Street, PH4-124, New York, NY, 10032, USA.
Curr Osteoporos Rep. 2017 Jun;15(3):207-213. doi: 10.1007/s11914-017-0366-z.
In this paper, we review the epidemiology, diagnosis, and pathogenesis of fractures and renal osteodystrophy.
The role of bone quality in the pathogenesis of fracture susceptibility in chronic kidney disease (CKD) is beginning to be elucidated. Bone quality refers to bone material properties, such as cortical and trabecular microarchitecture, mineralization, turnover, microdamage, and collagen content and structure. Recent data has added to our understanding of the effects of CKD on alterations to bone quality, emerging data on the role of abnormal collagen structure on bone strength, the potential of non-invasive methods to inform our knowledge of bone quality, and how we can use these methods to inform strategies that protect against bone loss and fractures. However, more prospective data is required. CKD is associated with abnormal bone quality and strength which results in high fracture incidence.
本文将对骨折和肾性骨营养不良的流行病学、诊断及发病机制进行综述。
慢性肾脏病(CKD)中骨质量在骨折易感性发病机制中的作用正逐渐明晰。骨质量指骨的材料特性,如皮质骨和小梁骨的微结构、矿化、转换、微损伤以及胶原蛋白含量和结构。近期数据增进了我们对CKD对骨质量改变影响的理解,关于异常胶原蛋白结构对骨强度作用的新数据,非侵入性方法在增进我们对骨质量了解方面的潜力,以及我们如何利用这些方法制定预防骨质流失和骨折策略。然而,还需要更多前瞻性数据。CKD与异常的骨质量和强度相关,这导致骨折发生率较高。