ArticleClinical nephrology2019
Serum bone markers in ROD patients across the spectrum of decreases in GFR: Activin A increases before all other markers .
Article in Clinical nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 32 citations in OpenAlex.
- Bone Turnover Markers, DXA and Mineral Metabolism in Long-Term Kidney Transplant Recipients: A Cross-Sectional Comparative Study.Journal of clinical medicine · 2026Article
- Serum activin A and bone metabolism in patients undergoing hemodialysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Bone turnover markers in the management of CKD-associated osteoporosis-a European consensus.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Review
- Diagnostic Accuracy of Bone Turnover Markers in Patients With CKD: A Systematic Review and Meta-Analysis.Kidney medicine · 2026Article
- Advances in noninvasive diagnosis of renal osteodystrophy.Renal failure · 2025Review
- Update on the role of bone turnover markers in the diagnosis and management of osteoporosis: a consensus paper from The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), International Osteoporosis Foundation (IOF), and International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Review
- Analysis of TGFβ1-Induced activin A gene expression in kidney mesangial cells.Frontiers in molecular biosciences · 2025Article
- Clinical Utility of Bone Turnover Markers in Chronic Kidney Disease.Journal of bone metabolism · 2024Article
- Application of artificial intelligence to chronic kidney disease mineral bone disorder.Clinical kidney journal · 2024Review
- In chronic kidney disease altered cardiac metabolism precedes cardiac hypertrophy.American journal of physiology. Renal physiology · 2024Article
- The Molecular Mechanisms Underlying the Systemic Effects Mediated by Parathormone in the Context of Chronic Kidney Disease.Current issues in molecular biology · 2024Review
- Plasma activin A rises with declining kidney function and is independently associated with mortality in patients with chronic kidney disease.Clinical kidney journal · 2023Article
- Article
- Updates in the chronic kidney disease-mineral bone disorder show the role of osteocytic proteins, a potential mechanism of the bone-Vascular paradox, a therapeutic target, and a biomarker.Frontiers in physiology · 2023Review
- Management of osteoporosis in patients with chronic kidney disease.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Review
- Review
- Bone Quality in CKD Patients: Current Concepts and Future Directions - Part I.Kidney diseases (Basel, Switzerland) · 2021Review
- Development of a quantitative systems pharmacology model of chronic kidney disease: metabolic bone disorder.American journal of physiology. Renal physiology · 2021Article
- Advances in the Progression and Prognosis Biomarkers of Chronic Kidney Disease.Frontiers in pharmacology · 2021Review
- Understanding Bone Disease in Patients with Diabetic Kidney Disease: a Narrative Review.Current osteoporosis reports · 2020Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
introductionRenal osteodystrophy (ROD) develops early in chronic kidney disease (CKD) and progresses with loss of kidney function. While intact parathyroid hormone (PTH), 1,25-dihydroxyvitamin D3 (1,25D), and fibroblast growth factor-23 (FGF-23) levels are usually considered the primary abnormalities in ROD development, the role of serum activin A elevations in CKD and its relationships to ROD have not been explored. The aims of this study were to evaluate serum activin A at different CKD stages, and to establish the relationships between activin A, bone biomarkers, and bone histomorphometric parameters. MATERIALS AND
methods104 patients with CKD stages 2 - 5D underwent bone biopsies. We measured in the serum activin A, BSAP, DKK1, FGF-23, α-Klotho, intact PTH, sclerostin, TRAP-5b, and 1,25D. Biochemical results were compared across CKD stages and with 19 age-matched controls with normal kidney function.
resultsMedian activin A levels were increased in all stages of CKD compared to controls from 544 pg/mL in CKD 2 (431 - 628) to 1,135 pg/mL in CKD 5D (816 - 1,456), compared to 369 pg/mL in controls (316 - 453, p < 0.01). The increase of activin A in CKD 2 (p = 0.016) occurred before changes in the other measured biomarkers. Activin A correlated with intact PTH and FGF-23 (r = 0.65 and 0.61; p < 0.01) and with histomorphometric parameters of bone turnover (BFR/BS, Acf, ObS/BS and OcS/BS; r = 0.47 - 0.52; p < 0.01). These correlations were comparable to those found with intact PTH and FGF-23.
conclusionSerum activin A levels increase starting at CKD 2 before elevations in intact PTH and FGF-23. Activin A correlates with bone turnover similar to intact PTH and FGF-23. These findings suggest a role for activin A in early development of ROD.
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