ABSTRACT We developed a voluntarily climbing animal model to investigate the effect of skeletal l... more ABSTRACT We developed a voluntarily climbing animal model to investigate the effect of skeletal loading on bone tissue. At the cross section of the mid-femur, climbing exercise increases outer diameter and area of cortical bone. The mechanical strength of the femur is increased. This change of cortical volume and structure is more marked in anti-gravity exercise, such as climbing and jumping, than aerobic exercise. At the bone marrow area, climbing exercise increases trabecular bone volume and osteoblast number, while it decreases fat volume and adipocyte number. Skeletal loading promotes differentiation from mesenchymal stem cells to osteoblasts and suppresses that to adipocytes by facilitating the signal through PTH÷PTHrP receptor.
Anemia is a common complication of patients with chronic kidney disease (CKD), which not only low... more Anemia is a common complication of patients with chronic kidney disease (CKD), which not only lowers their quality of life but also potentially causes cardiovascular diseases such as congestive heart failure and coronary heart disease, and accelerates the progression of renal dysfunction. Pre-dialysis patients were assigned to groups A, B, C or D based on hemoglobin levels of ≤ 8.9 (n = 48), 9.0-9.9 (n = 63), 10-10.9 (n = 53), and ≥ 11.0 g/dL (n = 39), respectively. Cardiac function was estimated using echocardiography to clarify the relationship between anemia and cardiac disorders in patients with CKD immediately before starting hemodialysis. Left ventricular ejection fraction (LVEF) was significantly higher in group D than in groups A and B. The fractions with an LVEF of less than 50% were 16.7, 4.8, 1.9, and 0% in groups A, B, C, and D, respectively. Posterior wall thickness was statistically thicker and the deceleration time of the early diastolic wave was longer in groups A and B, respectively, than in groups C and D. The left ventricular mass index in group D was significantly lower than in any other groups. Anemia in pre-dialysis patients with CKD is a probable cause of impaired left ventricular systolic function and progressive left ventricular hypertrophy. Our results suggest that Hb levels should be maintained at >11 g/dL by EPO administration from the perspective of protecting cardiac function, although the upper limit of the target Hb level was undetermined.
Since vascular calcification due to mineral disorder has been revealed a chief cause of decreasin... more Since vascular calcification due to mineral disorder has been revealed a chief cause of decreasing life expectancy of chronic kidney disease (CKD) patients in recent years, the term "renal osteodystrophy" can no longer express the pathophysiology of entire bone and mineral disorder in CKD. This is the reason why new disease entity "CKD-bone mineral disorden (MBD)" was introduced by the GBMI (Global Bone and Mineral Initiative) (one of the workgroups of KDIGO [Kidney Disease Improving Global Outcome]). GBMI has also produced new pathological classification of renal osteodystrophy (ROD) as TMV (turnover, mineralization, volume) classification and LBC (laboratory abnormalities, bone abnormalities, extra osseous calcification) classification for CKD-MBD.
Disturbances in bone and mineral metabolism in patients with chronic kidney disease (CKD) affect ... more Disturbances in bone and mineral metabolism in patients with chronic kidney disease (CKD) affect not only the bone diseases but also other organ disorders in the whole body and deteriorate the survival of these patients. The term CKD-Mineral and Bone Disorder (CKD-MBD) has been established describing a broader clinical syndrome that develops as a systemic disorder of mineral and bone metabolism due to CKD. Vascular calcification and secondary hyperparathyroidism are major diseases in CKD-MBD.
ABSTRACT We developed a voluntarily climbing animal model to investigate the effect of skeletal l... more ABSTRACT We developed a voluntarily climbing animal model to investigate the effect of skeletal loading on bone tissue. At the cross section of the mid-femur, climbing exercise increases outer diameter and area of cortical bone. The mechanical strength of the femur is increased. This change of cortical volume and structure is more marked in anti-gravity exercise, such as climbing and jumping, than aerobic exercise. At the bone marrow area, climbing exercise increases trabecular bone volume and osteoblast number, while it decreases fat volume and adipocyte number. Skeletal loading promotes differentiation from mesenchymal stem cells to osteoblasts and suppresses that to adipocytes by facilitating the signal through PTH÷PTHrP receptor.
Anemia is a common complication of patients with chronic kidney disease (CKD), which not only low... more Anemia is a common complication of patients with chronic kidney disease (CKD), which not only lowers their quality of life but also potentially causes cardiovascular diseases such as congestive heart failure and coronary heart disease, and accelerates the progression of renal dysfunction. Pre-dialysis patients were assigned to groups A, B, C or D based on hemoglobin levels of ≤ 8.9 (n = 48), 9.0-9.9 (n = 63), 10-10.9 (n = 53), and ≥ 11.0 g/dL (n = 39), respectively. Cardiac function was estimated using echocardiography to clarify the relationship between anemia and cardiac disorders in patients with CKD immediately before starting hemodialysis. Left ventricular ejection fraction (LVEF) was significantly higher in group D than in groups A and B. The fractions with an LVEF of less than 50% were 16.7, 4.8, 1.9, and 0% in groups A, B, C, and D, respectively. Posterior wall thickness was statistically thicker and the deceleration time of the early diastolic wave was longer in groups A and B, respectively, than in groups C and D. The left ventricular mass index in group D was significantly lower than in any other groups. Anemia in pre-dialysis patients with CKD is a probable cause of impaired left ventricular systolic function and progressive left ventricular hypertrophy. Our results suggest that Hb levels should be maintained at >11 g/dL by EPO administration from the perspective of protecting cardiac function, although the upper limit of the target Hb level was undetermined.
Since vascular calcification due to mineral disorder has been revealed a chief cause of decreasin... more Since vascular calcification due to mineral disorder has been revealed a chief cause of decreasing life expectancy of chronic kidney disease (CKD) patients in recent years, the term "renal osteodystrophy" can no longer express the pathophysiology of entire bone and mineral disorder in CKD. This is the reason why new disease entity "CKD-bone mineral disorden (MBD)" was introduced by the GBMI (Global Bone and Mineral Initiative) (one of the workgroups of KDIGO [Kidney Disease Improving Global Outcome]). GBMI has also produced new pathological classification of renal osteodystrophy (ROD) as TMV (turnover, mineralization, volume) classification and LBC (laboratory abnormalities, bone abnormalities, extra osseous calcification) classification for CKD-MBD.
Disturbances in bone and mineral metabolism in patients with chronic kidney disease (CKD) affect ... more Disturbances in bone and mineral metabolism in patients with chronic kidney disease (CKD) affect not only the bone diseases but also other organ disorders in the whole body and deteriorate the survival of these patients. The term CKD-Mineral and Bone Disorder (CKD-MBD) has been established describing a broader clinical syndrome that develops as a systemic disorder of mineral and bone metabolism due to CKD. Vascular calcification and secondary hyperparathyroidism are major diseases in CKD-MBD.
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