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Evaluation of mineral metabolism in patients with chronic kidney disease on peritoneal dialysis: correlation between clinical, biochemical and bone histology

Grant number: 10/06117-9
Support Opportunities:Regular Research Grants
Duration: August 01, 2010 - January 31, 2013
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
Associated researchers:Fabiana Giorgeti Graciolli ; Luciene Machado dos Reis ; Rodrigo Azevedo de Oliveira ; Rosa Maria Affonso Moysés


Chronic kidney disease (CKD) is frequent and constitutes an important worldwide public health problem. Disturbances in bone and mineral metabolism (DBMM) contribute to the adverse clinical evolution of this disease since they increase Patient morbidity and mortality. The association between DBMM and increased mortality rates is supported by significant evidence that alterations in bone remodeling favor the development of vascular calcifications. These calcifications compromise the integrity of the cardiovascular system and the development of cardiovascular diseases, which are the main causes of death of CKD Patients. DBMM is well documented in Patients on hemodialysis (HD). However, studies in Patients on peritoneal dialysis (PD) are rare, especially those with bone biopsy. These studies present methodological limitations and were performed when the principal phosphorus binder used by the Patients were made of calcium. This fact, associated with the high level of calcium in dialysis solutions, increased calcium overload in Patients, which might have influenced the bone disease pattern described in older studies. Despite the numerous biochemical markers in bone and mineral metabolism, the bone biopsy remains the gold standard. Our objective is to evaluate the prevalence of the different types of bone disease through the biopsy of the iliac crest of Patients on PD; evaluate the association of clinical and biochemical factors with the types of bone disease found; determine the prevalence of vascular calcifications through the X-ray of hands and hips; as well as study the correlations among DBMM and the types of bone disease found in the biopsy. In order to do that, it will be necessary to analyze 30 Patients with high bone remodeling and 30 Patients with low remodeling. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DE OLIVEIRA, RODRIGO A.; BARRETO, FELLYPE C.; MENDES, MONIQUE; DOS REIS, LUCIENE M.; CASTRO, JOAO HENRIQUE; BRITTO, ZITA MARIA L.; MARQUES, IGOR D. B.; CARVALHO, ALUIZIO B.; MOYSES, ROSA M.; JORGETTI, VANDA. Peritoneal dialysis per se is a risk factor for sclerostin-associated adynamic bone disease. Kidney International, v. 87, n. 5, p. 1039-1045, . (10/06117-9)

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