scholarly journals Energy-Dense Diets and Mineral Metabolism in the Context of Chronic Kidney Disease–Metabolic Bone Disease (CKD-MBD)

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1840
Author(s):  
Mariano Rodriguez ◽  
Escolastico Aguilera-Tejero
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Current Knowledge ◽  
Mineral Metabolism ◽  
Fibroblast Growth Factor 23 ◽  
Metabolic Bone

The aim of this paper is to review current knowledge about the interactions of energy-dense diets and mineral metabolism in the context of chronic kidney disease–metabolic bone disease (CKD-MBD). Energy dense-diets promote obesity and type II diabetes, two well-known causes of CKD. Conversely, these diets may help to prevent weight loss, which is associated with increased mortality in advanced CKD patients. Recent evidence indicates that, in addition to its nephrotoxic potential, energy-dense food promotes changes in mineral metabolism that are clearly detrimental in the context of CKD-MBD, such as phosphorus (P) retention, increased concentrations of fibroblast growth factor 23, decreased levels of renal klotho, and reduction in circulating concentrations of calcitriol. Moreover, in uremic animals, a high fat diet induces oxidative stress that potentiates high P-induced vascular calcification, and these extraskeletal calcifications can be ameliorated by oral supplementation of vitamin E. In conclusion, although energy-dense foods may have a role in preventing undernutrition and weight loss in a small section of the CKD population, in general, they should be discouraged in patients with renal disease, due to their impact on P load and oxidative stress.

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Felix Faustin Mungulluh ◽  
Paschal Ruggajo ◽  
Francis Fredrick Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

Comparison of Metabolic Bone Markers in Diabetic and Non-Diabetic Chronic Kidney Diseases in Government Medical College, Thrissur, Kerala, India

2021 ◽  
Vol 8 (29) ◽  
pp. 2578-2583
Author(s):  
Purnima Eliz Thomas ◽  
Pushpalatha M ◽  
Shajee Sivasankaran Nair ◽  
Sajeevan Kundil Chandran
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Bone Markers ◽  
Metabolic Bone Disease ◽  
Serum Levels ◽  
Medical College ◽  
Disease Markers ◽  
Metabolic Bone

BACKGROUND The term ‘Chronic Kidney Disease-Mineral and Bone Disorder’ (CKD-MBD) has been used to describe clinically, the abnormalities in the bone and mineral metabolism associated with CKD. In CKD, serum levels of metabolic bone disease markers generally reflect a high bone turnover state (hyperphosphatemia, hypocalcaemia, hypersecretion of PTH, increased ALP). However, it has been noted that in diabetic CKD patients on regular haemodialysis, there is an impaired secretion of PTH when compared to the non-diabetics on haemodialysis. In this study we intend to evaluate the serum bone markers in both diabetic and nondiabetic CHD patients. If a significant association can be demonstrated between diabetes mellitus and a low bone turnover state, then treatment guidelines can be tailored accordingly in the diabetic CHD patients. METHODS A hospital based cross-sectional study was done on 150 patients attending the Dialysis Unit of Govt. Medical College, Thrissur district, Kerala, India, from March 2014 to March 2015. Estimation of serum FBS, creatinine, calcium, phosphorus, ALP and PTH was done. RESULTS The mean levels of serum phosphorus and PTH are significantly lower in the diabetic CHD population than in the non-diabetics, but mean serum ALP is significantly higher in the diabetic CHD patients. Statistical significance is seen in the serum metabolic bone disease markers except calcium among diabetic and non-diabetic chronic kidney disease. CONCLUSIONS The serum levels of PTH and phosphorus were found to be significantly lower in diabetic CHD patients than in their non-diabetic counterparts. Serum ALP levels were significantly higher in the diabetics. This demonstrates that a relative hypoparathyroidism is prevalent among the diabetic CHD patients and hence, prevention of deterioration of the already existing low turnover bone disease in such patients should be the treatment motto. Avoidance of oral calcium supplements, vitamin D supplements and increased calcium in the dialysate would be ideal, since these can lead to hypercalcemia and further suppress the PTH secretion. KEYWORDS Diabetes Mellitus, Chronic Kidney Disease, Bone Markers

Imaging in Chronic Kidney Disease-Metabolic Bone Disease

2017 ◽  
Vol 30 (4) ◽  
pp. 361-368 ◽  
Author(s):  
Anup J. Alexander ◽  
David Jahangir ◽  
Martin Lazarus ◽  
Stuart M. Sprague
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Metabolic Bone

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Felix Faustin Mungulluh ◽  
Paschal Ruggajo ◽  
Francis Fredrick Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner. Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet. Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
FELIX FAUSTIN MUNGULLUH ◽  
Paschal Ruggajo ◽  
Francis F. Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software.Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

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