Evidence map›Paper›PMID 39985733›Full record

ReviewEuropean journal of clinical investigation2025

The autonomic nervous system and bone health in chronic kidney disease.

Carmine Zoccali, Marc G Vervloet, Pieter Evenepoel, Ziad Massy, Mario Cozzolino, Francesca Mallamaci, Eleanor D Lederer, Jorge Cannata Andia, Tilman B Drueke

Abstract readReview
In one paragraph

Review in European journal of clinical investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Carmine ZoccaliRenal Research Institute, New York, New York, USA.ORCID https://orcid.org/0000-0002-6616-1996
Marc G VervloetNephrology Department, Amsterdam UMC, Amsterdam, The Netherlands.
Pieter EvenepoelDepartment of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.
Ziad MassyInserm Unit 1018, Team 5, CESP, Hôpital Paul Brousse, Paris-Sud University (UPS) and Versailles Saint-Quentin-En-Yvelines University (Paris-Ile-de-France-Ouest University, UVSQ), Villejuif, France.
Mario CozzolinoRenal Division, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy.
Francesca MallamaciUnità Operativa di Nefrologia e Trapianto Renale, Grande Ospedale Metropolitano, Reggio Calabria, Italy.
Eleanor D LedererDepartment of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA.ORCID https://orcid.org/0000-0002-5935-3746
Jorge Cannata AndiaRedes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS2040, Kidney Disease), Madrid, Spain.
Tilman B DruekeInserm Unit 1018, Team 5, CESP, Hôpital Paul Brousse, Paris-Sud University (UPS), Villejuif, France.

Funding

CSRD VA I01 CX001614
6 · The paper itself

Abstract

Besides the well-known role of hormonal factors in mineral and bone metabolism, the sympathetic nervous system participates in this regulation by inhibiting bone formation and promoting bone resorption, primarily via β-adrenergic receptors expressed on osteoblasts. Conversely, the parasympathetic system, through cholinergic signalling, inhibits osteoclast activity, promoting bone formation and maintaining skeletal homeostasis. This review presents the role of the autonomic nervous system, with particular focus on the potential role of β-blockers, especially β1-selective blockers, in modulating bone health in people with normal kidney function and those with CKD. While early studies with non-selective β-blockers like propranolol showed mixed results, recent findings in postmenopausal women suggested that β1-selective β-blockers could enhance bone density by modulating sympathetic activity. Trial emulation using large databases and eventually randomized controlled trials are needed to test the hypothesis that β-blockade can favourably impact bone disease in patients with kidney failure.

Indexed as

Adrenergic beta-AntagonistsAutonomic Nervous SystemBone and BonesRenal Insufficiency, ChronicBone DensityFemaleHumansSympathetic Nervous SystemAdrenergic beta-Antagonistsautonomic dysfunctionbone diseaseCKDdialysis

Identifiers

PMID39985733
PMCPMC13288205

What OpenQuestion holds

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Registered trials

None linked

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.