Phosphate Binding with Sevelamer Preserves Mechanical Competence of Bone Despite Acidosis in Advanced Experimental Renal Insufficiency

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Jokihaara , J , Porsti , I H , Sievanen , H , Koobi , P , Kannus , P , Niemela , O , Turner , R T , Iwaniec , U T & Järvinen , T L N 2016 , ' Phosphate Binding with Sevelamer Preserves Mechanical Competence of Bone Despite Acidosis in Advanced Experimental Renal Insufficiency ' , PLoS One , vol. 11 , no. 9 , 0163022 . https://doi.org/10.1371/journal.pone.0163022

Title: Phosphate Binding with Sevelamer Preserves Mechanical Competence of Bone Despite Acidosis in Advanced Experimental Renal Insufficiency
Author: Jokihaara, Jarkko; Porsti, Ilkka H.; Sievanen, Harri; Koobi, Peeter; Kannus, Pekka; Niemela, Onni; Turner, Russell T.; Iwaniec, Urszula T.; Järvinen, Teppo L. N.
Contributor: University of Helsinki, Clinicum
Date: 2016-09-22
Language: eng
Number of pages: 16
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/168058
Abstract: Introduction Phosphate binding with sevelamer can ameliorate detrimental histomorphometric changes of bone in chronic renal insufficiency (CRI). Here we explored the effects of sevelamer-HCl treatment on bone strength and structure in experimental CRI. Methods Forty-eight 8-week-old rats were assigned to surgical 5/6 nephrectomy (CRI) or renal decapsulation (Sham). After 14 weeks of disease progression, the rats were allocated to untreated and sevelamer-treated (3% in chow) groups for 9 weeks. Then the animals were sacrificed, plasma samples collected, and femora excised for structural analysis (biomechanical testing, quantitative computed tomography). Results Sevelamer-HCl significantly reduced blood pH, and final creatinine clearance in the CRI groups ranged 30%-50% of that in the Sham group. Final plasma phosphate increased 2.4- to 2.9-fold, and parathyroid hormone 13- to 21-fold in CRI rats, with no difference between sevelamer-treated and untreated animals. In the femoral midshaft, CRI reduced cortical bone mineral density (-3%) and breaking load (-15%) (p Conclusions In this model of stage 3-4 CRI, sevelamer-HCl treatment ameliorated the decreases in femoral midshaft and neck mineral density, and restored bone strength despite prevailing acidosis. Therefore, treatment with sevelamer can efficiently preserve mechanical competence of bone in CRI.
Subject: CHRONIC KIDNEY-DISEASE
CHRONIC METABOLIC-ACIDOSIS
CALCIUM-CARBONATE
RAT FEMUR
HEMODIALYSIS-PATIENTS
PARATHYROID-HORMONE
PROXIMAL FEMUR
FAILURE RATS
FEMALE RATS
OSTEODYSTROPHY
3126 Surgery, anesthesiology, intensive care, radiology
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