Theme |
Testify the concepts of renal osteodystrophy and chronic kidney disease-bone and mineral disorder (CKD-MBD) |
Title |
Bone remodeling and modeling for dialysis patients |
Author |
Rikako Hiramatsu |
Nephrology Center, Toranomon Hospital |
Author |
Yoshifumi Ubara |
Nephrology Center, Toranomon Hospital |
[ Summary ] |
Bone remodeling undergoes sequential stages including activation, resorption, reversal and formation. This is observed as secondary osteons in cortical bone tissue and trabecular packets in cancellous bone tissue. In macromodeling, the macroscopic size of bone tissue increases with growth, without changes in basic configuration. In minimodeling, small hump-like new lamellar bone tissue is added from the quiescent surface without scalloping at the cement line between newly formed bone and original bone. Recent studies have been found, adynamic bone disease is frequently found in dialysis patients. Adynamic bone conditions are characterized by extremely low bone turnover due to a lack of osteoid formation. Minimodeling may contribute to maintaining bone volume in those patients with adynamic bone disease in the absence of remodeling stimulated by parathyroid hormones. Extraskleltal calcification is often found in patients with adynamic bone disease due to decrease calcium uptake by the bones. |