MicroRNAs: emerging biomarkers and therapeutic targets of bone fragility in chronic kidney disease

TY - JOUR

T1 - MicroRNAs: emerging biomarkers and therapeutic targets of bone fragility in chronic kidney disease

AU - Smout, Dieter

AU - Van Craenenbroeck, Amaryllis

AU - Jørgensen, Hanne Mari Skou

AU - Evenepoel, Pieter

PY - 2023/3/1

Y1 - 2023/3/1

N2 - Bone fragility is highly prevalent, yet underdiagnosed in patients with chronic kidney disease. Incomplete understanding of the pathophysiology and limitations of current diagnostics contribute to therapeutic hesitation, if not nihilism. This narrative review addresses the question of whether microRNAs (miRNAs) may improve therapeutic decision making in osteoporosis and renal osteodystrophy. miRNAs are key epigenetic regulators of bone homeostasis and show promise as both therapeutic targets and as biomarkers, primarily of bone turnover. Experimental studies show that miRNAs are involved in several osteogenic pathways. Clinical studies exploring the usefulness of circulating miRNAs for fracture risk stratification and for guiding and monitoring therapy are few and, so far, provide inconclusive results. Likely, (pre)analytical heterogeneity contributes to these equivocal results. In conclusion, miRNAs are promising in metabolic bone disease, both as a diagnostic tool and as therapeutic targets, but not yet ready for clinical prime time.

AB - Bone fragility is highly prevalent, yet underdiagnosed in patients with chronic kidney disease. Incomplete understanding of the pathophysiology and limitations of current diagnostics contribute to therapeutic hesitation, if not nihilism. This narrative review addresses the question of whether microRNAs (miRNAs) may improve therapeutic decision making in osteoporosis and renal osteodystrophy. miRNAs are key epigenetic regulators of bone homeostasis and show promise as both therapeutic targets and as biomarkers, primarily of bone turnover. Experimental studies show that miRNAs are involved in several osteogenic pathways. Clinical studies exploring the usefulness of circulating miRNAs for fracture risk stratification and for guiding and monitoring therapy are few and, so far, provide inconclusive results. Likely, (pre)analytical heterogeneity contributes to these equivocal results. In conclusion, miRNAs are promising in metabolic bone disease, both as a diagnostic tool and as therapeutic targets, but not yet ready for clinical prime time.

KW - CKD-MBD

KW - biomarker

KW - bone fragility

KW - bone remodeling

KW - bone turnover

KW - chronic kidney disease

KW - microRNA

KW - osteoporosis

KW - renal osteodystrophy

KW - transcriptomics

UR - http://www.scopus.com/inward/record.url?scp=85183350299&partnerID=8YFLogxK

U2 - 10.1093/ckj/sfac219

DO - 10.1093/ckj/sfac219

M3 - Review

C2 - 36865016

SN - 2048-8505

VL - 16

SP - 408

EP - 421

JO - Clinical Kidney Journal

JF - Clinical Kidney Journal

IS - 3

M1 - sfac219

ER -