Osteoporosis in Chronic Kidney Disease

• Grant number: 20/15744-9
• Support Opportunities: Research Projects - Thematic Grants
• Start date: February 01, 2023
• End date: January 31, 2028
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Vanda Jorgetti
• Grantee: Vanda Jorgetti
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• City of the host institution: São Paulo
• Principal investigators: Aluízio Barbosa de Carvalho ; Maria Eugênia Fernandes Canziani ; Rosa Maria Affonso Moysés
• Associated researchers: José Gilberto Henriques Vieira ; Lilian Cuppari ; Luciene Machado dos Reis ; Luzia Naoko Shinohara Furukawa ; Melani Ribeiro Custódio ; Monique Nakayama Ohe ; Rosilene Motta Elias Coelho
• Associated research grant(s): 25/19675-5 - Multi-user equipment approved in grant 2020/15744-9: OsteoMeasure High Resolution Digital Video System, AP.EMU; 24/09803-3 - The role of ultra-processed foods on mineral metabolism, bone mass and cardiovascular system in patients with Chronic Kidney Disease, AP.R SPRINT; 23/12819-6 - Multi-user Equipment approved in grant 2020/15744-9: Osteoprobe (impact microindenter based on reference point indentation technology), AP.EMU
• Associated scholarship(s): 25/10878-0 - Support and technical training for the thematic project OSteoporosis in CKD., BP.TT; 25/04872-0 - Study of the Relationship Between Different Circulating Forms of Parathyroid Hormone and Histomorphometric Parameters of Bone Biopsy in Patients with CKD and Bone Mass Loss Before and After Bisphosphonate Treatment, BP.DD; 24/23061-0 - Factors associated with endothelial dysfunction in patients with Chronic Kidney Disease and bone mass loss., BP.IC; + associated scholarships 24/15554-6 - Support and technical training for the thematic project "Osteoporosis in CKD"., BP.TT; 24/11179-6 - Support and technical training for the thematic project "Osteoporosis in CKD"., BP.TT; 24/04071-4 - Support and technical training for the thematic project "Osteoporosis in CKD"., BP.TT; 24/06479-0 - Analysis of the different circulating forms of PTH and their relationship with left ventricular hypertrophy in patients with CKD-MBD, BP.IC - associated scholarships

Abstract

Osteoporosis (OP) is defined as a systemic skeletal disease characterized by low mass and deterioration of bone tissue microarchitecture, with a consequent increased risk of fractures. OP is common and chronic kidney disease (CKD) is one of the main risk factors for its occurrence. CKD is associated with the complex mineral and bone disorders, named CKD-MBD, which is a syndrome characterized by biochemical, hormonal and bone metabolism disturbances. CKD patients, at all stages of the disease, are at increased risk of developing OP. However, in these patients, OP goes beyond its classic concept, since the factors related to CKD-MBD add to those found in the general population. As, until now, both the pathophysiology, the diagnosis and treatment of OP in CKD are not fully established, the need for a study that answers these questions is evident. The proposed project aims to obtain national data on the treatment of OP in patients with CKD, assess pathophysiological mechanisms, establish the value of the diagnostic methods and evaluate the efficacy and safety of treatment of OP with bisphosphonate in bone mass gain. The results of this study may impact the treatment of OP in this population, offering a level of evidence for the recommendations of national and international guidelines, currently based on opinion. Patients with CKD 2-4 from university outpatient clinics at USP and UNIFESP will participate in the study. This study comprises 11 subprojects, each one with its specific methodology, some observational and others with a prospective, double-blind design, randomized in the 1:1 ratio, with sodium alendronate and placebo. (AU)