{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:25:13Z","timestamp":1792794313506,"version":"4.5.0"},"reference-count":156,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Baxter Healthcare to Karolinska Institutet","id":[{"id":"https:\/\/ror.org\/056d84691","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Karolinska Institutet Diabetes Theme Center","id":[{"id":"https:\/\/ror.org\/056d84691","id-type":"ROR","asserted-by":"crossref"}]},{"name":"European Union\u2019s Horizon 2020","award":["722609"],"award-info":[{"award-number":["722609"]}]},{"name":"Heart and Lung Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Osteoporosis characterized by low bone mineral density (BMD) as assessed by dual-energy X-ray absorptiometry (DXA) is common among end-stage renal disease (ESRD) patients and associates with high fracture incidence and high all-cause mortality. This is because chronic kidney disease-mineral bone disorders (CKD-MBDs) promote not only bone disease (osteoporosis and renal dystrophy) but also vascular calcification and cardiovascular disease. The disturbed bone metabolism in ESRD leads to \u2018loss of cortical bone\u2019 with increased cortical porosity and thinning of cortical bone rather than to loss of trabecular bone. Low BMD, especially at cortical-rich bone sites, is closely linked to CKD-MBD, vascular calcification and poor cardiovascular outcomes. These effects appear to be largely mediated by shared mechanistic pathways via the \u2018bone\u2013vascular axis\u2019 through which impaired bone status associates with changes in the vascular wall. Thus, bone is more than just the scaffolding that holds the body together and protects organs from external forces but is\u2014in addition to its physical supportive function\u2014also an active endocrine organ that interacts with the vasculature by paracrine and endocrine factors through pathways including Wnt signalling, osteoprotegerin (OPG)\/receptor activator of nuclear factor-\u03baB (RANK)\/RANK ligand system and the Galectin-3\/receptor of advanced glycation end products axis. The insight that osteogenesis and vascular calcification share many similarities\u2014and the knowledge that vascular calcification is a cell-mediated active rather than a passive mineralization process\u2014suggest that low BMD and vascular calcification (\u2018vascular ossification\u2019) to a large extent represent two sides of the same coin. Here, we briefly review changes of BMD in ESRD as observed using different DXA methods (central and whole-body DXA) at different bone sites for BMD measurements, and summarize recent knowledge regarding the relationships between \u2018low BMD\u2019 and \u2018fracture incidence, vascular calcification and increased mortality\u2019 in ESRD patients, as well as potential \u2018molecular mechanisms\u2019 underlying these associations.<\/jats:p>","DOI":"10.1093\/ckj\/sfaa089","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T23:20:57Z","timestamp":1588029657000},"page":"307-321","source":"Crossref","is-referenced-by-count":54,"title":["Bone mineral density and mortality in end-stage renal disease patients"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6610-2451","authenticated-orcid":false,"given":"Ken","family":"Iseri","sequence":"first","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Medicine, Division of Nephrology, Showa University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-3857","authenticated-orcid":false,"given":"Lu","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhimin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden"},{"name":"Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0536-5327","authenticated-orcid":false,"given":"Abdul Rashid","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torkel B","family":"Brismar","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Radiology, Karolinska University Hospital, Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Stenvinkel","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Lindholm","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,26]]},"reference":[{"key":"2020071623393993200_sfaa089-B1","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1038\/nrneph.2014.185","article-title":"Chronic kidney disease and premature ageing","volume":"10","author":"Kooman","year":"2014","journal-title":"Nat Rev Nephrol"},{"key":"2020071623393993200_sfaa089-B2","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1007\/s00774-011-0307-3","article-title":"Measurement of subregional vertebral bone mineral density in vitro using lateral projection dual-energy X-ray absorptiometry: 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