A study of the natural history of bone and mineral disease (BMD) in patients with end-stage renal disease before and after kidney transplantation
Disturbances of mineral and bone diseaeses are frequently observed in CKD patients. Renal osteodystrophy is the term to describe the bone abnormalities. Epidemiological data showed adynamic bone disease (ABD) is the most frequent bone disorder in CKD stage 5D diseases. Low PTH, diabetes mellitus, malnutrition, metabolic acidosis, hypogonadism and low 1,25(OH)2D vitamin D deficiency are known risk factors for ABD. Mounting experimental data point towards a role of protein-bound uremic retention molecules (p-cresyl sulfate and indoxyl sulfate) in the pathogenesis and progression of ABD. ABD is not only recognized as a risk factor for fractures but also for arterial calcification. The aim of the present study is (1) to investigate the role of indoxyl sulfate and p-cresyl sulfate in the pathogenesis and progression of ABD and arterial calcification in CKD stage5 and (2) to investigate the influence of renal transplantation on bone and arterial metabolism.
Study Type
OBSERVATIONAL
Enrollment
250
UZ Leuven Gasthuisberg
Leuven, Vlaams-Brabant, Belgium
RECRUITINGbone turnover, as assessed by bone biopsy
to investigate the role of indoxyl sulfate and p-cresyl sulfate in the pathogenesis and progression of ABD and arterial calcification in CKD stage5
Time frame: at the start of the study
Evolution of bone turnover, as assessed by bone biopsy
to evoluation the evolution of bone turnover after succesfull renal transplantation
Time frame: after 1 year
aortic calcification, as assessed by lumbar X-ray
the assess the evolution of (the degree of) aortic calcification one year after succesfull renal transplantation
Time frame: 1 year
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