Open AccessThe importance of bone biopsy in chronic kidney disease–Mineral bone disorders
Author(s) -
Periklis Dousdampanis,
Kostantina Trigka
Publication year - 2017
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.215150
Subject(s) - bone biopsy , renal osteodystrophy , medicine , biopsy , chronic kidney disease mineral and bone disorder , kidney disease , parathyroid hormone , bone remodeling , bone pain , bone disease , pathology , osteoporosis , calcium
Renal osteodystrophy (ROD) is not a uniform bone disease; it is a heterogeneous group of metabolic bone diseases due to chronic kidney disease (CKD). The traditional term of ROD does not accurately include the wide spectrum of “CKD–mineral and bone disorder” (CKD–MBD) and has been restricted to define the several specific histologic disturbances of bone disease associated with CKD. Circulating parathyroid hormone (PTH) and total alkaline phosphatase levels do not always reflect bone turnover in CKD–MBD, whereas bone biopsy provides precise information regarding bone pathology. Given the lack of specificity of several biomarkers and noninvasive tools regarding ROD, bone biopsy is required for precise diagnosis and for the determination of therapeutic strategies. In clinical practice, bone biopsy is not performed due to lack of enthusiasm among nephrologists for several reasons including the invasiveness of the procedure, the potential pain, and lack of technical training. Since the application of bone biopsy in clinical practice is unrealistic, several biomarkers with specificity for bone disease should be studied