Association of Serum Bicarbonate with Bone Fractures in Hemodialysis Patients: The Mineral and Bone Disorder Outcomes Study for Japanese CKD Stage 5D Patients (MBD-5D)

@article{Kato2014AssociationOS,
  title={Association of Serum Bicarbonate with Bone Fractures in Hemodialysis Patients: The Mineral and Bone Disorder Outcomes Study for Japanese CKD Stage 5D Patients (MBD-5D)},
  author={Akihiko Kato and Ryo Kido and Yoshihiro Onishi and Noriaki Kurita and Masafumi Fukagawa and Tadao Akizawa and Shunichi Fukuhara},
  journal={Nephron Clinical Practice},
  year={2014},
  volume={128},
  pages={79 - 87}
}
Background/Aims: Bone fracture is often complicated in hemodialysis (HD) patients. Metabolic acidosis is related to bone disease and muscle wasting, but it is not known whether acid-base disturbance is associated with the risk of bone fractures. The aim of this study was to clarify the association of serum bicarbonate level with bone fracture in HD patients. Methods: Using a subcohort of the Mineral and Bone Disorder Outcomes Study for Japanese CKD Stage 5D Patients (MBD-5D), 890 prevalent HD… 

Figures and Tables from this paper

Fractures in patients with chronic kidney disease
  • S. Dudar
  • Medicine, Biology
    Ukrainian Journal of Nephrology and Dialysis
  • 2021
TLDR
The clarifying of the appropriateness of medicines that act directly on the bone or affect the mineral and hormonal metabolism could be a promising strategy to prevent pathological fractures due to fragility among CKD patients.
Chronic kidney disease and fragility fracture
  • J. Kazama
  • Medicine, Biology
    Clinical and Experimental Nephrology
  • 2016
TLDR
The use of drugs that directly act on bone and the introduction of fracture liaison concept are promising strategies for fragility fracture prevention among CKD patients, as well as treatment for CKD-MBD.
Should chronic metabolic acidosis be treated in older people with chronic kidney disease?
  • M. Witham, E. Lamb
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2016
TLDR
Whether bicarbonate therapy can improve physical function, quality of life, and vascular, bone and kidney health in older people, and hence decide whether any benefits seen outweigh adverse effects and additional treatment burden in this vulnerable group of patients is to be decided.
University of Dundee Should chronic metabolic acidosis be treated in older people with chronic kidney disease ?
TLDR
Whether bicarbonate therapy can improve physical function, quality of life, vascular, bone and kidney health in older people, and hence decide whether any benefits seen outweigh adverse effects and additional treatment burden in this vulnerable group of patients is to be decided.
Metabolic acidosis status and mortality in patients on the end stage of renal disease
  • V. Raikou
  • Medicine
    Journal of translational internal medicine
  • 2016
TLDR
Uncorrected severe metabolic acidosis, defined by serum bicarbonate concentrations less than 20 mmol/L, is associated with a 10-year risk for coronary heart disease more than 20% and high overall mortality in patients on renal replacement therapy.
Sodium bicarbonate to improve physical function in patients over 60 years with advanced chronic kidney disease: the BiCARB RCT.
TLDR
Oral sodium bicarbonate did not improve a range of health measures in people aged ≥ 60 years with chronic kidney disease category 4 or 5 and mild acidosis, and is unlikely to be cost-effective for use in the NHS in this patient group.
Adverse Effects of the Metabolic Acidosis of Chronic Kidney Disease.
TLDR
Administration of base decreases muscle wasting, improves bone disease, restores responsiveness to insulin, slows progression of CKD, and possibly reduces mortality, and the target serum [HCO3-] remains unclear.
Mortality and complications after hip fracture among elderly patients undergoing hemodialysis
TLDR
The overall mortality and complication rates of hemodialysis subjects after surgery for hip fracture were significantly higher than those of non-hemodialysis Subjects, and further prospective studies which include important risk factors are necessary to more precisely quantify the adjusted effect of he modialysis.
Skeletal Consequences of Nephropathic Cystinosis
  • P. Florenzano, C. Ferreira, M. Collins
  • Medicine
    Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
  • 2018
TLDR
It is concluded that skeletal deformities, decreased bone mass, and vertebral fractures are common and relevant complications of nephropathic cystinosis, even before renal transplantation, and efforts to minimize risk factors for skeletal disease include optimizing mineral metabolism and hormonal status.
...
...

References

SHOWING 1-10 OF 59 REFERENCES
Mineral Metabolism Management in Hemodialysis Patients with Secondary Hyperparathyroidism in Japan: Baseline Data from the MBD-5D
TLDR
The severity of SHPT and the use of dialysate with higher calcium concentration are associated with practical difficulty in managing mineral metabolism in dialysis patients.
Mineral and Bone Disorders Outcomes Study for Japanese Chronic Kidney Disease Stage 5D Patients: Rationale and Study Design
  • S. Fukuhara, T. Akizawa, K. Kurokawa
  • Medicine
    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
  • 2011
TLDR
This study is a three‐year prospective observational study with a case‐cohort and a cohort design to provide evidence regarding factors that affect outcomes in hemodialysis patients with secondary hyperparathyroidism.
Fracture Risk Assessment in Chronic Kidney Disease, Prospective Testing Under Real World Environments (FRACTURE): a prospective study
TLDR
By identifying risk factors for fracture and targeting treatments in this group-before the initiation of renal replacement therapy - this study will reduce the burden of disease due to fractures among patients with CKD.
Clinical Epidemiology of Long-bone Fractures in Patients Receiving Hemodialysis
TLDR
Examination of hospital discharge claims from 1994 through 1999 for 7159 subjects in the Dialysis Morbidity and Mortality Study suggested the adverse prognosis of long-bone fractures was related to subsequent congestive heart failure, stroke, pulmonary embolism, pneumonia, and septicemia.
Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study.
TLDR
The results suggest that greater selectivity in prescribing several classes of psychoactive drugs and more efficient treatment of secondary hyperparathyroidism may help reduce the burden of fractures in HD patients.
Renal bone disease in 76 patients with varying degrees of predialysis chronic renal failure: a cross-sectional study
TLDR
It is postulated that adynamic bone disease is a form of renal osteodystrophy, separate from osteomalacia, appearing when bone resistance to PTH develops, probably a transient stage to more advanced hyperparathyroid histological classes with increasing severity of chronic renal failure.
Renal bone disease in 76 patients with varying degrees of predialysis chronic renal failure: a cross-sectional study.
  • G. Coen, S. Mazzaferro, F. Taggi
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 1996
TLDR
It is postulated that adynamic bone disease is a form of renal osteodystrophy, separate from osteomalacia, appearing when bone resistance to PTH develops, probably a transient stage to more hyperparathyroid histological classes with increasing severity of chronic renal failure.
Correction of metabolic acidosis with potassium citrate in renal transplant patients and its effect on bone quality.
TLDR
Treatment with potassium citrate in renal transplant patients is efficient and well tolerated for correction of metabolic acidosis and may be associated with improvement in bone quality.
PTH and the risks for hip, vertebral, and pelvic fractures among patients on dialysis.
TLDR
Prospective studies are needed to determine whether therapies that maintain PTH concentrations within or near the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative range will result in fewer complications of disordered mineral metabolism.
Vascular calcifications, vertebral fractures and mortality in haemodialysis patients
TLDR
Positive associations between vascular calcifications, vertebral fractures and mortality have been found in patients on haemodialysis.
...
...