An update on bone imaging and markers in chronic kidney disease

ABSTRACT

Introduction: Bone disorders in chronic kidney disease (CKD) are associated with heightened risks of fractures, vascular calcification, poor quality of life and mortality compared to the general population. However, diagnosis and management of these disorders in CKD are complex and appreciably limited by current diagnostic modalities.

Areas covered: Bone histomorphometry remains the gold standard for diagnosis but is not widely utilised and lacks feasibility as a monitoring tool. In practice, non-invasive imaging and biochemical markers are preferred to guide therapeutic decisions.

Expert commentary: This review aims to summarize the risk factors for, and spectrum of bone disease in CKD, as well as appraise the clinical utility of dual energy X-ray densitometry, peripheral quantitative computed tomography, high-resolution peripheral quantitative computed tomography, and bone turnover markers.

KEYWORDS:

• Alkaline phosphatase
• biomarker
• bone and bones/radiography
• bone density
• bone diseases
• bone turnover markers
• chronic kidney disease
• dual energy X-ray densitometry
• fibroblast growth factors
• fracture
• klotho
• high-resolution peripheral quantitative computed tomography
• parathyroid hormone
• peripheral quantitative computed tomography
• renal bone disease
• renal dialysis
• renal osteodystropy
• SOST protein

Declaration of interest

D Johnson is a consultant for Baxter Healthcare Pty Ltd and has previously received research funds from this company. He has also received speakers’ honoraria and research grants from Fresenius Medical Care. Associate Professor Carmel Hawley has received research funding from Baxter Healthcare Pty Ltd, Shire Pty. Limited and Fresenius Medical Care. She has received travel grants from Amgen Australia. R Krishnasamy has received speaking honoraria from Shire Australia. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

No funding was received.