Molecular Abnormalities Underlying Bone Fragility in Chronic Kidney Disease.

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Term Occurence Count Dictionary
diabetes mellitus 1 endocrinologydiseases
hyperparathyroidism 3 endocrinologydiseases
secondary hyperparathyroidism 2 endocrinologydiseases
vascular calcification 2 endocrinologydiseases
Denosumab 4 endocrinologydiseasesdrugs
Teriparatide 2 endocrinologydiseasesdrugs
hyperphosphatemia 1 endocrinologydiseases
osteoporosis 29 endocrinologydiseases
raloxifene 1 endocrinologydiseasesdrugs

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Select Drug Character Offset Drug Term Instance
Denosumab 21930 have low affinity to hydroxyapatite crystals, such as risedronate and ibandronate, should be chosen. Denosumab , a human monoclonal antibody for the receptor activator of nuclear factor-kappa B, does not accumulate
Denosumab 22505 lumber spine and femoral neck in hemodialysis patients, although the sample size was small [[114]]. Denosumab may induce hypocalcemia through strong suppression of bone resorption, which tends to be amplified in
Denosumab 22639 through strong suppression of bone resorption, which tends to be amplified in CKD patients [[115]]. Denosumab should be prescribed with active vitamin D to regulate the calcium balance.Raloxifene, a selective estrogen
Denosumab 30821 abnormalitiesDialysis (stage 5D)Alendronate+−+Risedronate+−−Etidronate−−−Ibandronate+++Minodronate+++ Denosumab +++Raloxifene+++Teriparatide++++: use with caution; −: avoid use
Teriparatide 23176 group [[117]]. However, reduced serum calcium concentration and increased PTH secretion were reported. Teriparatide is a recombinant protein of PTH (1–34) and an anabolic agent for the treatment of postmenopausal osteoporosis.
Teriparatide 30846 5D)Alendronate+−+Risedronate+−−Etidronate−−−Ibandronate+++Minodronate+++Denosumab+++Raloxifene+++ Teriparatide ++++: use with caution; −: avoid use
raloxifene 22939 increases in BMD were associated with lower creatinine clearance [[116]]. In another study, patients on raloxifene showed slower progression of kidney disorders and significantly fewer kidney-related adverse events
Select Disease Character Offset Disease Term Instance
diabetes mellitus 1747 properties of bone.1. IntroductionElderly people are susceptible to diseases such as hypertension, diabetes mellitus , and chronic obstructive pulmonary disease. Osteoporosis and chronic kidney disease (CKD) are also common,
hyperparathyroidism 1179 There are many uremia-associated factors that contribute to bone fragility, including severe secondary hyperparathyroidism , skeletal resistance to parathyroid hormone, and bone mineralization disorders. Uremia also aggravates
hyperparathyroidism 10831 medical and surgical treatments for severe hyperactive parathyroid function have progressed, and moderate hyperparathyroidism is unlikely to be a major risk factor for skeletal fragility.Disturbed bone remodeling (marked decreases
hyperparathyroidism 23429 should be used with caution in osteoporotic patients with CKD due to higher blood PTH level in secondary hyperparathyroidism associated with CKD, intermittent PTH administration can be used to induce an anabolic effect on bone
hyperphosphatemia 25395 only for fracture prevention but also for reducing cardiovascular mortality in CKD patients.Control of hyperphosphatemia is important for CKD patients to prevent cardiovascular events and reduce the risk of death. From a
osteoporosis 1062 Additionally, uremia-related bone fragility has a more complicated pathological process compared to osteoporosis . There are many uremia-associated factors that contribute to bone fragility, including severe secondary
osteoporosis 1558 oxidative stress. In this review, we outline the prevalence of fractures, the interaction of CKD-MBD with osteoporosis in CKD patients, and discuss possible factors that exacerbate the mechanical properties of bone.1. IntroductionElderly
osteoporosis 4728 key bone lesions accompanying CKD are CKD-mineral bone disorder (CKD-MBD), renal osteodystrophy, and osteoporosis , but their definitions are often ambiguous. CKD-MBD is a syndrome defined by the Kidney Disease: Improving
osteoporosis 5736 strength is not typically mentioned. Impairment of mechanical properties of bone comes under the term “ osteoporosis ,” as defined by the National Institute of Health. This pathophysiology is characterized by compromised
osteoporosis 6099 quality. Bone mass is a strong determinant of bone strength and is useful as a diagnostic tool for osteoporosis in people with extremely low bone mass. As there are no other tools to predict and/or monitor bone strength
osteoporosis 6338 practice, bone mass measurement is considered the most informative and useful tool available to diagnosis osteoporosis . Bone mass, however, is not the only determining factor. Other factors affecting bone mechanical strength
osteoporosis 7121 fractures are observed in postmenopausal women with a T-score above −2.5 SD, the threshold for diagnosing osteoporosis defined by the World Health Organization [[24]–[26]]. Additionally, postmenopausal women with fragility
osteoporosis 7457 [[27]–[29]]. Therefore, bone mass measurement is strictly not the standard method for diagnosing osteoporosis .With the progression of renal function impairment, fracture risk is remarkably high in CKD. While we
osteoporosis 7584 progression of renal function impairment, fracture risk is remarkably high in CKD. While we suspect that osteoporosis may underlie the increased risk of fracture in CKD, the mechanism may differ from that of primary osteoporosis
osteoporosis 7695 osteoporosis may underlie the increased risk of fracture in CKD, the mechanism may differ from that of primary osteoporosis characterized by marked reduction in bone mass. It is also unclear whether osteoporosis (bone fragility)
osteoporosis 7783 of primary osteoporosis characterized by marked reduction in bone mass. It is also unclear whether osteoporosis (bone fragility) associated with CKD is derived from CKD-MBD or factors other than CKD-MBD.4. Possible
osteoporosis 17685 material properties are altered in CKD patients with fragile bone has not been confirmed, uremia-related osteoporosis causing bone fragility should exist in CKD.7. Microcracks and Osteocyte ApoptosisBecause one of the
osteoporosis 19173 Fractures in CKD PatientsIn the general population, pharmacotherapy is the mainstay of management for osteoporosis . Patients with primary osteoporosis are treated with different types of drugs. Guidelines for primary
osteoporosis 19209 general population, pharmacotherapy is the mainstay of management for osteoporosis. Patients with primary osteoporosis are treated with different types of drugs. Guidelines for primary osteoporosis recommend antiresorptive
osteoporosis 19288 Patients with primary osteoporosis are treated with different types of drugs. Guidelines for primary osteoporosis recommend antiresorptive drugs (bisphosphonates, antagonists of osteoclasts, and selective estrogen
osteoporosis 19707 excreted via the kidneys. The KDIGO guidelines [[30]] indicate that extrapolating results from studies of osteoporosis in general population to patients with CKD stages 3–5D may not be valid, with concerns over long-term
osteoporosis 19880 not be valid, with concerns over long-term safety because the pathogenesis differs between primary osteoporosis and CKD-MBD-related osteoporosis. On the other hand, due to the increases in osteoporosis and CKD with
osteoporosis 19913 long-term safety because the pathogenesis differs between primary osteoporosis and CKD-MBD-related osteoporosis . On the other hand, due to the increases in osteoporosis and CKD with advancing age and the proven safety
osteoporosis 19970 between primary osteoporosis and CKD-MBD-related osteoporosis. On the other hand, due to the increases in osteoporosis and CKD with advancing age and the proven safety profile of osteoporotic agents, the KDIGO guidelines
osteoporosis 20191 approve the use of these agents in early CKD patients with high risk of fracture, including patients with osteoporosis and CKD stages 1-2. Potential treatments with antiosteoporotic agents in different CKD stages are summarized
osteoporosis 20460 agents will be discussed in detail below.Although bisphosphonates have become a standard treatment for osteoporosis , bisphosphonates should not be used in patients with stages 4-5 CKD because these drugs are excreted
osteoporosis 21774 not been established [[112]]. If it is necessary to use bisphosphonates for the management of severe osteoporosis in patients with CKD, bisphosphonates that have low affinity to hydroxyapatite crystals, such as risedronate
osteoporosis 22161 because its point of action is limited. Its efficacy in CKD is expected to be the same as that in primary osteoporosis . A previous study reported that the efficacy of denosumab, which increases BMD and suppresses fractures,
osteoporosis 23288 is a recombinant protein of PTH (1–34) and an anabolic agent for the treatment of postmenopausal osteoporosis . Although teriparatide should be used with caution in osteoporotic patients with CKD due to higher blood
osteoporosis 24055 romosozumab and blosozumab, a new class of drugs with novel mechanisms of action, are being developed for osteoporosis treatment. In clinical trials, romosozumab and blosozumab have been shown to increase bone mass concomitant
osteoporosis 26240 pathophysiological conditions associated with renal failure is an appropriate strategy for the treatment of osteoporosis in CKD.9. ConclusionDetermining the pathogenesis of osteoporosis and treatment efficacy is difficult
osteoporosis 26305 appropriate strategy for the treatment of osteoporosis in CKD.9. ConclusionDetermining the pathogenesis of osteoporosis and treatment efficacy is difficult in CKD patients because of the complicated mineral and bone abnormalities
osteoporosis 28177 clinicians, pharmacologists, nurses, drug companies, and other authorities should pay particular attention to osteoporosis in CKD patients to determine suitable management.Figure 1Possible factors involved in bone fragility.
osteoporosis 30558 apoptosis Modulating material property [[101]–[103]]Numerals are reference numbers.Table 3Pharmacotherapies for osteoporosis according to stage of chronic kidney disease (CKD).AgentsCKD stage ≤ 3 without biochemical abnormalitiesCKD
secondary hyperparathyroidism 1169 osteoporosis. There are many uremia-associated factors that contribute to bone fragility, including severe secondary hyperparathyroidism , skeletal resistance to parathyroid hormone, and bone mineralization disorders. Uremia also aggravates
secondary hyperparathyroidism 23419 teriparatide should be used with caution in osteoporotic patients with CKD due to higher blood PTH level in secondary hyperparathyroidism associated with CKD, intermittent PTH administration can be used to induce an anabolic effect on bone
vascular calcification 2527 low parathyroid hormone (PTH) level, female gender, low body mass index, and presence of peripheral vascular calcification . Several studies report that nondialysis patients aged over 50 with estimated glomerular filtration
vascular calcification 5254 abnormalities in bone turnover, mineralization, volume, and strength; and soft tissue calcification including vascular calcification . This disease may manifest one component or any combination of the three. According to this definition,

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