Evidence map›Paper›PMID 39528063›Full record

ArticleBone2025

Static histomorphometry parameters can identify bone turnover status in children and adults with chronic kidney disease.

Jan M Hughes-Austin, Renata C Pereira, Vanda D Jorgetti, Isidro B Salusky, Joachim H Ix

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Article in Bone, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Jan M Hughes-AustinDepartment of Orthopaedic Surgery, School of Medicine, University of California, San Diego, La Jolla, CA, USA. Electronic address: jhughesaustin@health.ucsd.edu.
Renata C PereiraDepartment of Pediatrics, School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Vanda D JorgettiUniversity of São Paulo, São Paulo, Brazil.
Isidro B SaluskyDepartment of Pediatrics, School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Joachim H IxDivision of Nephrology-Hypertension, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA; Veterans Affairs San Diego, La Jolla, CA, USA.

Funding

Hip Fracture Pathology in Chronic Kidney DiseaseR01AG065876 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Jan Marie Hughes-Austin · 2020 to 2026
$3.8M
Mentored Patient Oriented Research in Kidney DiseaseK24DK110427 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI IX, JOACHIM H · 2016 to 2020
$780k
NIA NIH HHS R01 AG065876NIDDK NIH HHS K24 DK110427
6 · The paper itself

Abstract

introductionTetracycline labeling for bone biopsy facilitates quantification of the pace of new bone production. As tetracycline labeling needs to be done prior to biopsy, it cannot be used to assess bone turnover in patients presenting with fractures, yet knowing turnover rate in patients experiencing fractures - especially in those with chronic kidney disease (CKD) - may guide appropriate medical therapy after surgical repair. Therefore, we sought to determine the diagnostic accuracy of static markers of bone turnover relative to tetracycline labeling in a pediatric and adult cohort of patients with chronic kidney disease (CKD) undergoing iliac crest biopsy with histomorphometry.

methodsWe evaluated two cohorts, one of 147 children and young adults ages 18±10 and another of 151 adults ages 49±13 who had undergone iliac crest biopsy with tetracycline labeling for clinical indications of CKD-mineral and bone disorders. We used bone formation rate relative to bone surface (BFR/BS) based on double tetracycline labeling as our gold standard marker of bone turnover. A blinded investigator used light microscopy without fluorescence to measure static bone turnover parameters. We compared the area under the ROC curve (AUC), sensitivity, and specificity of each static parameter with low and high bone turnover based on BFR/BS.

resultsIn the pediatric and adult cohorts, 35 (24 %) and 70 (46 %) had low bone turnover, respectively, and 18 (12 %) and 30 (20 %) had high bone turnover, respectively. The static parameters with the greatest AUCs for low and high turnover were osteoblast surface/bone surface (Ob.S/BS), osteoclast surface/bone surface (Oc.S/BS), eroded surface/bone surface (ES/BS), osteoid surface/bone surface (OS/BS), osteoid volume/bone volume (OV/BV), and osteoid thickness (O.Th.) in both cohorts. Ob.S/BS had the highest AUC for low and high turnover in the pediatric cohort (0.8204 and 0.8678, respectively) whereas Oc.S/BS had the highest AUC for low turnover (0.8325) and ES/BS had the highest AUC for high turnover (0.7360) in the adult cohort. DISCUSSION: Static measures of histomorphometry that do not rely on tetracycline bone labeling can identify low and high bone turnover in children and adults with CKD with moderate to high accuracy. This approach may allow assessment of bone turnover in the setting of clinical fractures where clinicians may have access to bone tissue but where tetracycline labeling is not available.

Indexed as

Bone RemodelingRenal Insufficiency, ChronicAdolescentAdultBiopsyChildCohort StudiesFemaleHumansMaleMiddle AgedROC CurveTetracyclineYoung AdultTetracyclineBone histomorphometryBone turnoverChronic kidney diseaseMineral and bone disorder

Identifiers

PMID39528063
PMCPMC13155198

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.