Early impairment of trabecular microarchitecture assessed with HR-pQCT in patients with stage II-IV chronic kidney disease

Bacchetta, Justine; Boutroy, Stéphanie; Vilayphiou, Nicolas; Juillard, Laurent; Guebre-Egziabher, Fitsum; Rognant, Nicolas; Sornay-Rendu, Elisabeth; Szulc, Pawel; Laville, Maurice; Delmas, Pierre D.; Fouque, Denis; Chapurlat, Roland

Affiliations

¹Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rhumatologie Pédiatriques, Hôpital Femme Mère Enfant, Bron, France

²Université de Lyon, Lyon, France

³INSERM U831, Lyon, France

⁴Département de Néphrologie, Hôpital Edouard Herriot, Lyon, France

Abstract and keywords

Bone fragility is a complication of chronic kidney disease (CKD). The aim of this study was to assess whether volumetric bone mineral density (vBMD) and microarchitecture could be impaired early in the course of CKD. Bone microarchitecture was examined with a noninvasive 3D imaging technique [high-resolution peripheral quantitative computed tomography (HR-pQCT)] at the tibia and radius in 70 stage II-IV CKD patients older than 50 years of age; controls belonged to two cohorts of healthy subjects comparable for age and gender (OFELY cohort in women and STRAMBO cohort in men). We examined 46 men and 24 women; 19 patients were diabetic. Mean age was 70.8 ± 8.5 years, mean glomerular filtration rate (GFR) was 34 ± 12 mL/min per 1.73 m², and mean serum parathyroid hormone (PTH) level was 87 ± 59 pg/mL. Both CKD men and women experienced a moderate but significant trabecular (Tb) impairment, positioning CKD patient values between those of normal and osteopenic controls (e.g., CKD men versus healthy controls: Tb vBMD 172 ± 35 versus 188 ± 34 mg HA/cm³; Tb number 1.75 ± 0.27 versus 1.86 ± 0.26 mm⁻¹, and Tb separation 503 ± 94 versus 465 ± 78 µm; p < .05). Cortical thickness (Ct.Th) in men also was significantly decreased compared with healthy controls (e.g., CKD men versus healthy controls: tibial Ct.Th 1171 ± 331 versus 1288 ± 283 µm; p < .05). In conclusion, this study, using a noninvasive bone-imaging device, shows for the first time an early impairment of trabecular microarchitecture in stage II-IV CKD patients. Further longitudinal studies should be performed to validate HR-pQCT as a tool for predicting the fracture risk in CKD.

Keywords: bone imaging; chronic kidney disease; HR-pQCT; trabecular microarchitecture

Links

DOI: 10.1359/jbmr.090831

PubMed: 19775204

WoS: 000277189400017

History

Received: 2008-12-22

Revised: 2009-07-29

Accepted: 2009-08-27

Online: 2009-08-31

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Cited By (13)

Year	Entry
2015	Manske SL, Zhu Y, Sandino C, Boyd SK. Human trabecular bone microarchitecture can be assessed independently of density with second generation HR-pQCT. Bone. October 2015;79:213-221.
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2021	Bover J, Ureña-Torres P, Cozzolino M, Rodríguez-García M, Gómez-Alonso C. The non-invasive diagnosis of bone disorders in CKD. Calcif Tiss Int. April 2021;108(4):512-527.
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2010	Burghardt AJ, Kazakia GJ, Sode M, de Papp AE, Link TM, Majumdar S. A longitudinal HR-pQCT study of alendronate treatment in postmenopausal women with low bone density: relations among density, cortical and trabecular microarchitecture, biomechanics, and bone turnover. J Bone Miner Res. December 2010;25(12):2558-2571.
2016	Burt LA, Liang Z, Sajobi TT, Hanley DA, Boyd SK. Sex‐ and site‐specific normative data curves for HR‐pQCT. J Bone Miner Res. November 2016;31(11):2041-2047.
2022	Bobillier A, Wagner P, Whittier DE, Ecochard R, Boyd SK, Chapurlat R, Szulc P. Association of vitamin D and parathyroid hormone status with the aging-related decline of bone microarchitecture in older men: the Prospective Structure of Aging Men's Bones (STRAMBO) study. J Bone Miner Res. October 2022;37(10):1903-1914.
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2010	Burghardt AJ, Issever AS, Schwartz AV, Davis KA, Masharani U, Majumdar S, Link TM. High-resolution peripheral quantitative computed tomographic imaging of cortical and trabecular bone microarchitecture in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2010;95(11):5045-5055.
2020	Whittier DE, Boyd SK, Burghardt AJ, Paccou J, Ghasem-Zadeh A, Chapurlat R, Engelke K, Bouxsein ML. Guidelines for the assessment of bone density and microarchitecture in vivo using high-resolution peripheral quantitative computed tomography. Osteoporos Int. September 2020;31(9):1607-1627.
2019	Du J. Mechanical Adaptation of Human Trabecular Bone: Experimental and Computational Study [PhD thesis]. Loughborough University; 2019.
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2020	Sharma AK. Evaluation of Renal Bone Disease: Advancing Our Understanding of Associations and Diagnostic Challenges [PhD thesis]. University of Melbourne; April 2020.