Clinical utility of bone turnover markers in patients with chronic kidney disease

TY - JOUR

T1 - Clinical utility of bone turnover markers in patients with chronic kidney disease

AU - Smout, Dieter

AU - Jørgensen, Hanne S.

AU - Cavalier, Etienne

AU - Evenepoel, Pieter

N1 - Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.

PY - 2022/7

Y1 - 2022/7

N2 - Purpose of reviewThe burden of fractures is very high in patients with chronic kidney disease (CKD). It is increasingly recognized that knowledge of bone turnover is of paramount importance in guiding mineral metabolism and osteoporosis therapy in CKD. Bone histomorphometry is the gold standard to assess bone turnover, but is seldomly performed in clinical practice. Bone turnover markers (BTMs) may be the long awaited noninvasive diagnostic that may help to close the therapeutic gap in patients with advanced CKD presenting with bone fragility.Recent findingsMounting evidence indicates that BTMs may be useful in skeletal and nonskeletal risk stratification, in guiding mineral metabolism and osteoporosis therapy, and in monitoring the therapeutic response.SummaryBTMs provide information that is complementary to other clinical tests. It may be envisioned that in the near future, the assessment of nonkidney cleared BTMs may become part of routine clinical evaluation and monitoring of bone health in CKD patients, integrated with clinical risk factors, imaging data and, eventually, bone histomorphometry. Panels of BTMs will likely be more informative than single markers, and the same might hold true for trends as opposed to single time point data.

AB - Purpose of reviewThe burden of fractures is very high in patients with chronic kidney disease (CKD). It is increasingly recognized that knowledge of bone turnover is of paramount importance in guiding mineral metabolism and osteoporosis therapy in CKD. Bone histomorphometry is the gold standard to assess bone turnover, but is seldomly performed in clinical practice. Bone turnover markers (BTMs) may be the long awaited noninvasive diagnostic that may help to close the therapeutic gap in patients with advanced CKD presenting with bone fragility.Recent findingsMounting evidence indicates that BTMs may be useful in skeletal and nonskeletal risk stratification, in guiding mineral metabolism and osteoporosis therapy, and in monitoring the therapeutic response.SummaryBTMs provide information that is complementary to other clinical tests. It may be envisioned that in the near future, the assessment of nonkidney cleared BTMs may become part of routine clinical evaluation and monitoring of bone health in CKD patients, integrated with clinical risk factors, imaging data and, eventually, bone histomorphometry. Panels of BTMs will likely be more informative than single markers, and the same might hold true for trends as opposed to single time point data.

KW - bone fractures

KW - bone histomorphometry

KW - bone turnover marker

KW - chronic kidney disease - mineral and bone disorder

KW - chronic renal insufficiency

UR - http://www.scopus.com/inward/record.url?scp=85132453425&partnerID=8YFLogxK

U2 - 10.1097/MNH.0000000000000798

DO - 10.1097/MNH.0000000000000798

M3 - Review

C2 - 35703216

AN - SCOPUS:85132453425

SN - 1062-4821

VL - 31

SP - 332

EP - 338

JO - Current Opinion in Nephrology and Hypertension

JF - Current Opinion in Nephrology and Hypertension

IS - 4

ER -