Scholarlink

<p>Although no large studies have shown that exercise helps maintain bone volume in the two representative types of renal osteodystrophy (ROD), some case reports have supported this effect, leading to speculation about the usefulness of exercise in these conditions. Dialysis patients can develop chronic kidney disease–mineral and bone disorder, which includes bone lesions termed ROD. Examples of ROD lesions are osteitis fibrosa (high-turnover bone) due to secondary hyperparathyroidism, which is associated with high parathyroid hormone (PTH) levels, and adynamic bone (low-turnover bone) due to hypoparathyroidism, which is associated with low PTH levels. In osteitis fibrosa, osteoblastic bone formation and osteoclastic bone resorption occur simultaneously in different locations, double tetracycline (Tc) labeling is observed, and a woven bone structure is characteristic. Moderate exercise promotes bone formation and maintains bone mass and volume and connectivity of cancellous bone. However, if patients do not exercise enough, bone resorption becomes dominant, the cancellous bone becomes osteopenic and is replaced by fatty marrow, the dense cortical bone becomes more porous, osteocyte nuclei are lost, and empty lacunae develop. In adynamic bone, tests show no evidence of active osteogenesis by osteoblasts, no bone resorption by osteoclasts, and no Tc labeling, but studies have shown that exercise may help maintain bone mass by minimodeling and improving lamellar bone structure. Osteocyte nuclei are visible. In patients with renal failure, 1,25(OH)<sub>2</sub>D<sub>3</sub> levels are inevitably decreased, so administration of activated vitamin D<sub>3</sub> derivative is necessary; if activated vitamin D<sub>3</sub> derivative is not administered, mineralization is impaired, and osteomalacia occurs. In all types of ROD, continued appropriate exercise increases bone mass, whereas cessation of exercise leads to bone loss. This article presents bone biopsy results in hemodialysis patients with and without exercise. The purpose of this review is to speculate on the importance of exercise in each condition on the basis of previously published case reports, with some new cases added.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Potential effects of exercise on bone biopsy findings in patients receiving hemodialysis: a review of our case series

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月5日

查看全文
  • Yoshifumi Ubara,
  • Izuru Kitajima,
  • Akemi Ito,
  • Naoki Sawa

摘要

Although no large studies have shown that exercise helps maintain bone volume in the two representative types of renal osteodystrophy (ROD), some case reports have supported this effect, leading to speculation about the usefulness of exercise in these conditions. Dialysis patients can develop chronic kidney disease–mineral and bone disorder, which includes bone lesions termed ROD. Examples of ROD lesions are osteitis fibrosa (high-turnover bone) due to secondary hyperparathyroidism, which is associated with high parathyroid hormone (PTH) levels, and adynamic bone (low-turnover bone) due to hypoparathyroidism, which is associated with low PTH levels. In osteitis fibrosa, osteoblastic bone formation and osteoclastic bone resorption occur simultaneously in different locations, double tetracycline (Tc) labeling is observed, and a woven bone structure is characteristic. Moderate exercise promotes bone formation and maintains bone mass and volume and connectivity of cancellous bone. However, if patients do not exercise enough, bone resorption becomes dominant, the cancellous bone becomes osteopenic and is replaced by fatty marrow, the dense cortical bone becomes more porous, osteocyte nuclei are lost, and empty lacunae develop. In adynamic bone, tests show no evidence of active osteogenesis by osteoblasts, no bone resorption by osteoclasts, and no Tc labeling, but studies have shown that exercise may help maintain bone mass by minimodeling and improving lamellar bone structure. Osteocyte nuclei are visible. In patients with renal failure, 1,25(OH)2D3 levels are inevitably decreased, so administration of activated vitamin D3 derivative is necessary; if activated vitamin D3 derivative is not administered, mineralization is impaired, and osteomalacia occurs. In all types of ROD, continued appropriate exercise increases bone mass, whereas cessation of exercise leads to bone loss. This article presents bone biopsy results in hemodialysis patients with and without exercise. The purpose of this review is to speculate on the importance of exercise in each condition on the basis of previously published case reports, with some new cases added.