Evidence map›Paper›PMID 42599620›Full record

ArticleArchives of osteoporosis2026

Clinical risk factors associated with bone biopsy findings in CKD-associated osteoporosis: insights from the Brazilian Registry of Bone Biopsy (REBRABO).

Eduardo J Duque, Lauren S Lowe, Cinthia E M Carbonara, Rodrigo B Oliveira, Thomas L Nickolas, Rosilene M Elias, Vanda Jorgetti, Luciene Dos Reis, Aluizio B Carvalho, Michael T Yin and 1 more

Abstract read
In one paragraph

Article in Archives of osteoporosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Eduardo J DuqueNephrology Department, Laboratório de Fisiopatologia Renal (LIM16), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3º Andar, sala 3342, São Paulo, SP, CEP 01246 903, Brazil.
Lauren S LoweColumbia University Irving Medical Center, New York, NY, USA.
Cinthia E M CarbonaraUNICAMP, Campinas, SP, Brazil.
Rodrigo B OliveiraUNICAMP, Campinas, SP, Brazil.
Thomas L NickolasDivision of Bone and Mineral Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Rosilene M EliasNephrology Department, Laboratório de Fisiopatologia Renal (LIM16), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3º Andar, sala 3342, São Paulo, SP, CEP 01246 903, Brazil.
Vanda JorgettiNephrology Department, Laboratório de Fisiopatologia Renal (LIM16), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3º Andar, sala 3342, São Paulo, SP, CEP 01246 903, Brazil.
Luciene Dos ReisNephrology Department, Laboratório de Fisiopatologia Renal (LIM16), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3º Andar, sala 3342, São Paulo, SP, CEP 01246 903, Brazil.
Aluizio B CarvalhoNephrology Department, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Michael T YinColumbia University Irving Medical Center, New York, NY, USA.
Rosa M MoysesNephrology Department, Laboratório de Fisiopatologia Renal (LIM16), Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 3º Andar, sala 3342, São Paulo, SP, CEP 01246 903, Brazil. rosa.moyses@uol.com.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic kidney disease-associated osteoporosis (CKD-OP) is a highly prevalent-yet frequently underrecognized-condition in patients with advanced CKD. The assessment of bone turnover, mineralization, and volume remains challenging in clinical practice, often requiring bone histomorphometric analysis. Using data from the Brazilian Registry of Bone Biopsies (REBRABO), we identified clinical characteristics associated with these histomorphometric parameters. These findings may help clinicians better characterize the underlying bone phenotype and support a more individualized approach to the diagnosis and management of CKD-associated osteoporosis. PURPOSE: Chronic kidney disease-associated osteoporosis (CKD-OP) is characterized by impaired bone quality, and management of bone fragility in CKD partially relies on evaluating bone turnover (T), mineralization (M), and volume (V), through bone biopsy. However, bone biopsy data from large population-based cohorts are limited, making it challenging to identify clinical parameters that are associated with TMV patterns.

methodsThis cross-sectional study is based on data from the Brazilian Registry of Bone Biopsy (REBRABO) and includes 374 iliac crest bone biopsies from adult patients with CKD5D (median age 51 y), collected between August/15 and December/21. Each biopsy was classified according to bone turnover (low/normal vs. high), mineralization (normal vs. abnormal), and trabecular volume (normal vs. low). Demographic and laboratory parameters were also analyzed.

resultsNo significant differences in TMV classification were observed based on ethnicity, sex, or diabetes status. Higher turnover was independently associated with younger age, hemodialysis modality, elevated parathyroid hormone (PTH), and alkaline phosphatase (ALP) levels, in a model adjusted for dialysis vintage, prior parathyroidectomy (PTX), and phosphate. Abnormal mineralization was independently associated with age, prior PTX, and lower serum calcium and phosphate, after adjustment for body mass index (BMI), PTH, and ALP. Low trabecular volume was independently associated with older age and lower BMI, in a model adjusted for PTH and history of fractures, and cannot be reliably inferred from biochemical markers. Notably, most patients with adynamic bone also presented with low trabecular volume.

conclusionOur findings suggest that younger patients undergoing hemodialysis with elevated PTH and ALP levels may benefit from a more intensive approach to the management of hyperparathyroidism. In contrast, older and more frail patients with relatively low PTH levels may be more likely to exhibit low bone volume and turnover and could potentially benefit from therapies aimed at stimulating bone formation, such as anabolic agents.

Indexed as

Bone and BonesOsteoporosisRenal Insufficiency, ChronicAdultAgedBiopsyBone DensityBone RemodelingBrazilCross-Sectional StudiesFemaleHumansIliumMaleMiddle AgedRegistriesBone biopsyCKDMineral metabolismOsteoporosisRenal osteodystrophy

Identifiers

PMID42599620
PMCPMC13476351

What OpenQuestion holds

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Registered trials

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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.