Effects of parathyroidectomy on the biology of bone tissue in patients with chronic kidney disease and secondary hyperparathyroidism

Author(s):Show less -

Pires, Geovanna O. ^[1] ; Vieira, Itamar O. ^[1] ; Hernandes, Fabiana R. ^[2] ; Teixeira, Andre L. ^[1] ; Oliveira, Ivone B. ^[3] ; Dominguez, Wagner V. ^[1] ; dos Reis, Luciene M. ^[1] ; Montenegro, Fabio M. ^[4] ; Moyses, Rosa M. ^{[5, 1]} ; Carvalho, Aluizio B. ^[2] ; Jorgetti, Vanda ^{[1, 6]}

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, LIM 16 Lab Fisiopatol Renal, Sao Paulo, SP - Brazil

^[2] Univ Fed Sao Paulo, Div Nefrol, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Fac Med FMUSP, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Fac Med, HCFMUSP, Dept Cirurgia, Hosp Clin, Sao Paulo, SP - Brazil

^[5] Univ Nove de Julho UNINOVE, Programa Posgrad Med, Sao Paulo, SP - Brazil

^[6] Hosp Samaritano Amer, Serv Med, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: BONE; v. 121, p. 277-283, APR 2019.
• Web of Science Citations: 3

Abstract

Secondary hyperparathyroidism is a complication of chronic kidney disease that compromises skeletal integrity. In patients with secondary hyperparathyroidism undergoing parathyroidectomy, parathyroid hormone levels dramatically decrease. The effects of parathyroidectomy on bone tissue are poorly understood, especially regarding the proteins expressed by osteocytes, such as fibroblast growth factor 23, dentin matrix protein 1, matrix extracellular phosphoglycoprotein, sclerostin, receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin, which regulate bone turnover. The objective of this study was to characterize the bone expression of these proteins by immunohistochemistry and correlate these results with those of bone histomor-phometry before and after parathyroidectomy. We studied bone biopsies that were obtained from 23 patients before and 12 months after parathyroidectomy. We observed an improvement in bone microarchitecture, but impaired mineralization after parathyroidectomy. We found significant increases in sclerostin and osteoprotegerin expression and a decrease in the RANKL/osteoprotegerin ratio after parathyroidectomy, suggesting that their expression is regulated by parathormone. These proteins correlated with structural and bone formation parameters. We conclude that after parathyroidectomy, significant changes occur in the bone expression of osteocyte proteins and that these proteins potentially regulate bone remodeling. (AU)

• FAPESP's process: 15/13126-8 - Parathyroidectomy effects on bone tissue, body composition, energy metabolism in patients with chronic kidney disease and secondary hyperparathyroidism
• Grantee: Vanda Jorgetti
• Support Opportunities: Regular Research Grants