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dc.contributor.authorBarreto, Fellype Carvalho [UNIFESP]
dc.contributor.authorBarreto, Daniela Veit
dc.contributor.authorMoysés, Rosa Maria Affonso
dc.contributor.authorNeves, C. L.
dc.contributor.authorJorgetti, Vanda
dc.contributor.authorDraibe, Sergio Antonio [UNIFESP]
dc.contributor.authorCanziani, Maria Eugenia [UNIFESP]
dc.contributor.authorCarvalho, A. B.
dc.identifier.citationKidney International. New York: Nature Publishing Group, v. 69, n. 10, p. 1852-1857, 2006.
dc.description.abstractOsteoporosis in hemodialysis patients is associated with high morbidity and mortality and, although extensively studied by noninvasive methods, has never been assessed through bone biopsy. the aim of this study was to use histomorphometry to evaluate osteoporosis and identify factors related to its development in hemodialysis patients. We conducted a cross-sectional study involving 98 patients ( 35 women and 63 men; mean age: 48.4 +/- 13 years) on hemodialysis for 36.9 +/- 24.7 months. Patients were submitted to transiliac bone biopsy with double tetracycline labeling. the bone metabolism factors ionized calcium, phosphorus, bone alkaline phosphatase, deoxypyridinoline, intact parathyroid hormone, and 25( OH) vitamin D were evaluated, as were the bone remodeling cytokines osteoprotegerin (OPG), soluble receptor-activator of NF-kappa beta ligand (sRANKL) and tumor necrosis factor-alpha (TNF)alpha. Osteoporosis was defined as trabecular bone volume ( BV/ TV) greater than 1 s.d. below normal ( men < 17.4%; women < 14.7%). Forty-five patients (46%) presented osteoporosis, which was correlated with white race. We found BV/ TV to correlate with age, OPG/sRANKL ratio, TNF alpha levels, and length of amenorrhea. in multiple regression analysis adjusted for sex and age, length of amenorrhea, white race, and OPG/ sRANKL ratio were independent determinants of BV/TV. Histomorphometric analysis demonstrated that osteoporotic patients presented normal eroded surface and low bone formation rate (BFR/BS). Osteoporosis is prevalent in hemodialysis patients. Low BFR/BS could be involved in its development, even when bone resorption is normal. Cytokines may also play a role as may traditional risk factors such as advanced age, hypogonadism, and white race.en
dc.publisherNature Publishing Group
dc.relation.ispartofKidney International
dc.rightsAcesso aberto
dc.subjectbone diseasesen
dc.subjectbone histomorphometryen
dc.titleOsteoporosis in hemodialysis patients revisited by bone histomorphometry: A new insight into an old problemen
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.description.affiliationUniversidade Federal de São Paulo, Dept Internal Med, Div Nephrol, BR-04038002 São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Div Nephrol, Dept Internal Med, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Internal Med, Div Nephrol, BR-04038002 São Paulo, Brazil
dc.description.sourceWeb of Science
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