scholarly journals Hibernation, puberty and chronic kidney disease in troglodytes from Spain half a million years ago

2018 ◽  
Author(s):  
Antonis Bartsiokas ◽  
Juan Luis Arsuaga
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Life Histories ◽  
Physiological Mechanism ◽  
Human Species ◽  
Mineral And Bone Disorder ◽  
Femoral Trochlea ◽  
Sima De Los Huesos ◽  
Fence Post

Both animal hibernation (heterothermy) and human renal osteodystrophy are characterized by high levels of serum parathyroid hormone. To test the hypothesis of hibernation in an extinct human species, we examined the hominin skeletal collection from Sima de los Huesos, Cave Mayor, Atapuerca, Spain, for evidence of hyperparathyroidism. We studied the morphology of the fossilized bones by using macrophotography, microscopy, histology and CT scanning. We found trabecular tunneling and osteitis fibrosa, subperiosteal resorption,‘rotten fence post’ signs,brown tumours, subperiosteal new bone, chondrocalcinosis, rachitic osteoplaques and empty gaps between them, craniotabes, and beading in ribs mostly in the adolescent population of these hominins. Since many of the above lesions are pathognomonic, these extinct hominins suffered annually from renal rickets, secondary hyperparathyroidism, and renal osteodystrophy associated with Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). We suggest these diseases were caused by non-tolerated hibernation in dark cavernous hibernacula. This is evidenced by the rachitic osteoplaques and the gaps between them mainly in the adolescent individuals along with the evidence of healing mainly in the adults. The sublayers in the rachitic osteoplaques point to bouts of arousal from hibernation. The strong projection of the external lip of the femoral trochlea, the rachitic osteoplaques with the empty gaps between them,the “rotten fence post sign”, and the evidence of annual healing caused by non-tolerated hibernation in adolescent individuals, also point to the presence of annually intermittent puberty in this population. The hypothesis of hibernation is consistent with the genetic evidence and the fact that the SH hominins lived during a glacial period. The present work will provide a new insight into the physiological mechanism of early human metabolism which could help in determining the life histories and physiologies of extinct human species.

scholarly journals Hibernation, puberty and chronic kidney disease in troglodytes from Spain half a million years ago

2018 ◽  
Author(s):  
Antonis Bartsiokas ◽  
Juan Luis Arsuaga
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Life Histories ◽  
Physiological Mechanism ◽  
Human Species ◽  
Mineral And Bone Disorder ◽  
Femoral Trochlea ◽  
Sima De Los Huesos ◽  
Fence Post

Both animal hibernation (heterothermy) and human renal osteodystrophy are characterized by high levels of serum parathyroid hormone. To test the hypothesis of hibernation in an extinct human species, we examined the hominin skeletal collection from Sima de los Huesos, Cave Mayor, Atapuerca, Spain, for evidence of hyperparathyroidism. We studied the morphology of the fossilized bones by using macrophotography, microscopy, histology and CT scanning. We found trabecular tunneling and osteitis fibrosa, subperiosteal resorption,‘rotten fence post’ signs,brown tumours, subperiosteal new bone, chondrocalcinosis, rachitic osteoplaques and empty gaps between them, craniotabes, and beading in ribs mostly in the adolescent population of these hominins. Since many of the above lesions are pathognomonic, these extinct hominins suffered annually from renal rickets, secondary hyperparathyroidism, and renal osteodystrophy associated with Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). We suggest these diseases were caused by non-tolerated hibernation in dark cavernous hibernacula. This is evidenced by the rachitic osteoplaques and the gaps between them mainly in the adolescent individuals along with the evidence of healing mainly in the adults. The sublayers in the rachitic osteoplaques point to bouts of arousal from hibernation. The strong projection of the external lip of the femoral trochlea, the rachitic osteoplaques with the empty gaps between them,the “rotten fence post sign”, and the evidence of annual healing caused by non-tolerated hibernation in adolescent individuals, also point to the presence of annually intermittent puberty in this population. The hypothesis of hibernation is consistent with the genetic evidence and the fact that the SH hominins lived during a glacial period. The present work will provide a new insight into the physiological mechanism of early human metabolism which could help in determining the life histories and physiologies of extinct human species.

Chronic kidney disease-mineral and bone disorder

2018 ◽  
Author(s):  
Stuart M. Sprague ◽  
Menaka Sarav
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Mineral Metabolism ◽  
Bone Biopsy ◽  
Fibroblast Growth Factor 23 ◽  
Critical Role ◽  
Specific Treatment ◽  
Mineral And Bone Disorder ◽  
Bone Disorder

The kidneys play a critical role in maintaining normal serum calcium and phosphorus concentrations, under the regulation of three main hormones: parathyroid hormone, calcitriol, and fibroblast growth factor 23. With the progression of chronic kidney disease (CKD), most patients develop CKD–mineral and bone disorder (CKD-MBD), which is a systemic disorder involving derangement in mineral metabolism, renal osteodystrophy, and extraskeletal calcification. Disturbances in mineral metabolism develop early in CKD and include phosphate retention, hypocalcaemia, vitamin D deficiency, and hyperparathyroidism. Renal osteodystrophy involves pathologic changes of bone morphology related to progressive CKD and is quantifiable by histomorphometry, based on bone biopsy. CKD-MBD is associated with significant morbidity, including bone loss, fractures, cardiovascular disease, immune suppression, as well as increased mortality. As the disorder begins early in the course of CKD, a proactive approach with intervention is important. Therapeutic strategies could then be employed to prevent and correct these disturbances, aiming to improve cardiovascular outcomes and survival. Current practice guidelines for CKD-MBD are based on insufficient data and high-quality studies are required before specific treatment can be advocated strongly.

scholarly journals THE SPECTRUM OF RENAL OSTEODYSTROPHY – NOVEL AND OLD PARADIGMS

2016 ◽  
Vol 25 (1) ◽  
pp. 5-13
Author(s):  
Violeta Bojinca ◽  
◽  
Daria Popescu ◽  
Cristina Capusa ◽  
◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Assessment Tools ◽  
Ectopic Calcification ◽  
Mineral And Bone Disorder ◽  
Major Cardiovascular Events ◽  
Cardiovascular Morbidity And Mortality ◽  
Significant Impairment ◽  
Renal Bone Disease

“Chronic kidney disease-related mineral and bone disorder” is a newly introduced concept which replaced the former term of “renal osteodystrophy” or “renal bone disease”. It highlights the need for understanding the complex relationships among calcium-phosphate axis, bone metabolism, ectopic calcification and cardiovascular morbidity and mortality in patients with chronic kidney disease. It has the merit to shift the focus from monitoring and treating separate biochemical abnormalities at all costs to the greater aim of improvement survival and reducing major cardiovascular events. However, mainly because of the lack of reliable assessment tools, the bone disorders component is discussed to a much lesser extent even it accounts for major physical disabilities and result in significant impairment of the quality of life. Therefore, the current review aimed to briefly remind the older and newer knowledge in the field of bone changes that occur during the course of chronic kidney disease.

scholarly journals Parathyroid Hormone Measurement in Chronic Kidney Disease: From Basics to Clinical Implications

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Kittrawee Kritmetapak ◽  
Chatlert Pongchaiyakul
Keyword(s):  
Chronic Kidney Disease ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Biologically Active ◽  
Intact Pth ◽  
Current Standard ◽  
Mineral And Bone Disorder ◽  
Wide Range ◽  
Serum Pth

Accurate measurement of parathyroid hormone (PTH) is crucial for therapeutic decision-making in patients with chronic kidney disease-mineral and bone disorder (CKD-MBD). The second-generation PTH assays, often referred to as “intact PTH” assays, are the current standard and most available assays in clinical practice. However, intact PTH assays measure both full-length biologically active PTH and heterogeneous PTH fragments in the circulation, providing the equivocal value of PTH measurement in patients with CKD-MBD. Due to the variability of PTH assays, preanalytical sample errors, and the phenomenon of end-organ PTH hyporesponsiveness, current CKD-MBD guidelines recommend a wide range for serum PTH targets (2–9 the upper normal limit of the intact PTH assay) in dialysis patients to diminish the risk of developing adynamic bone disease. Nevertheless, a sizeable proportion of CKD patients still experience renal osteodystrophy despite having serum PTH levels within the recommended range. The primary cause of this inconsistency is the analytical interference of various PTH fragments and oxidized PTH forms that considerably accumulate in CKD patients. Therefore, a new mass spectrometry-based assay, which is capable of specifically measuring the whole spectra of PTH fragments, can potentially improve diagnostic accuracy for renal osteodystrophy. However, the effects of different PTH fragments on bone metabolism, vascular calcification, and mortality in CKD patients warrant further research.

Chronic Kidney Disease – Mineral Bone Disorder

2008 ◽  
Vol 28 (2_suppl) ◽  
pp. 5-10
Author(s):  
Sharon M. Moe
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Osteodystrophy ◽  
Consensus Conference ◽  
Mineral And Bone Disorder ◽  
Mineral Bone Disorder ◽  
Bone Disorder ◽  
The Many ◽  
Bone Abnormalities

The definition, evaluation, and classification of the mineral abnormalities and bone disease in chronic kidney disease (CKD) should encompass all three clinical components: • Abnormalities in serum biochemistries • Vascular calcification • Bone abnormalities This principle was discussed at a Kidney Disease: Improving Global Outcomes consensus conference, resulting in a recognition of the shortcomings of the current classification and a recommendation for the development of new terminology. The recommendation was that the term “renal osteodystrophy” be used exclusively to define the bone pathology associated with CKD. The many clinical, biochemical, and imaging abnormalities that have heretofore been identified as correlates of renal osteodystrophy should be defined more broadly as a clinical entity or syndrome called “chronic kidney disease – mineral and bone disorder.” The hope is that this new terminology will enhance communication and facilitate research worldwide.

Sign in / Sign up

Export Citation Format

Share Document