Brazilian Journal of Nephrology (Oct 2023)

Renal osteodystrophy and clinical outcomes: a prospective cohort study

  • Cinthia Esbrile Moraes Carbonara,
  • Joaquim Barreto,
  • Noemi Angelica Vieira Roza,
  • KélciaRosana da Silva Quadros,
  • Luciene Machado dos Reis,
  • Aluízio Barbosa de Carvalho,
  • Andrei C. Sposito,
  • Vanda Jorgetti,
  • Rodrigo Bueno de Oliveira

DOI
https://doi.org/10.1590/2175-8239-jbn-2023-0119en

Abstract

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Abstract Introduction: Renal osteodystrophy (ROD) refers to a group of bone morphological patterns that derive from distinct pathophysiological mechanisms. Whether the ROD subtypes influence long-term outcomes is unknown. Our objective was to explore the relationship between ROD and clinical outcomes. Methods: This study is a subanalysis of the Brazilian Registry of Bone Biopsies (REBRABO). Samples from individual patients were classified as having osteitis fibrosa (OF), mixed uremic osteodystrophy (MUO), adynamic bone disease (ABD), osteomalacia (OM), normal/minor alterations, and according to turnover/mineralization/volume (TMV) system. Patients were followed for 3.4 yrs. Clinical outcomes were: bone fractures, hospitalization, major adverse cardiovascular events (MACE), and death. Results: We enrolled 275 participants, of which 248 (90%) were on dialysis. At follow-up, 28 bone fractures, 97 hospitalizations, 44 MACE, and 70 deaths were recorded. ROD subtypes were not related to outcomes. Conclusion: The incidence of clinical outcomes did not differ between the types of ROD.

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