Patients with chronic renal insufficiency usually develop secondary osteoporosis or bone loss, which is called renal osteodystrophy. Most of the previous studies focused on bone metabolism of patients in late stage of chronic renal insufficiency, especially those with chronic dialysis. In this study, bone metabolism of patients in different stages of chronic renal insufficiency will be observed to reveal the mechanism of development of renal osteodystrophy and provide clues for early intervention on renal osteodystrophy.
In this study, patients with chronic renal insufficiency (CKD1-5, defined by glomerular filtration rate,GFR) and healthy people as control will be recruited (50/group, total 300). Blood urea nitrogen, creatinine,lumbar and hip bone mineral density, bone turnover biochemical markers including serum total propeptide of type I procollagen(PINP), bone alkaline phosphatase(BALP), bone Gla-protein (BGP) and β-CrOSSlaps(β-CTX), serum calcium and phosphorus and related regulators including fibroblast growth factor 23 (FGF23), 25-hydroxyl-Vitamin D (25-OH-VitD), parathyroid hormone(PTH) will be detected. The relationship between kidney function and bone turnover, and the rules throughout the development process of renal osteodystrophy will be analysed.The micro ribonucleotide(miRNA)array will also be performed to screen the biomarkers of renal osteodystrophy in different stage.
Study Type
OBSERVATIONAL
Enrollment
300
Anhui Province Hospital of TCM
Hefei, Anhui, China
RECRUITINGJiangsu Province Hospital of TCM
Nanjing, Jiangsu, China
SUSPENDEDLonghua hospital affiliated to Shanghai University of TCM
Shanghai, Shanghai Municipality, China
RECRUITINGHuadong Hospital Affiliated to Fudan University
Shanghai, Shanghai Municipality, China
COMPLETEDbone metabolism (bone mineral density and serum bone turnover biomarkers)
lumbar (L1-4 as well as total) and hip (neck, troch, inter and word's) bone mineral density will be recorded by dual energy X-ray absorptiometry. Serum bone turnover biomarkers including total PINP, BGP, BALP and β-CTx will be detected.
Time frame: 1 day after enrollment
Kidney function (blood creatinine and urea nitrogen,glomerular filtration rate)
CKD1-5 will be graded by glomerular filtration rate,and blood creatinine and urea nitrogen will be detected.
Time frame: 1 day after enrollment
Calcium and phosphorus metabolism (serum calcium and phosphorus,calcium-phosphorus product, FGF23, PTH and 25-OH-VitD)
Serum calcium and phosphorus will be detected and the calcium-phosphorus product will be calculated.Factors which are related with calcium and phosphorus including FGF23, PTH and 25-OH-VitD will be detected.
Time frame: 1 day after enrollment
MicroRNA array
Blood plasma will be collected for microRNA array analysis to find specific biomarkers for each stage.We will also try to find biomarkers for better definitions of chronic renal insufficiency and renal osteodystrophy.
Time frame: 1 day after enrollment
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