{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:29:10Z","timestamp":1791613750765,"version":"4.3.4"},"reference-count":66,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:00:00Z","timestamp":1603411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000291","name":"Kidney Research UK","doi-asserted-by":"publisher","award":["TF_002_20161124"],"award-info":[{"award-number":["TF_002_20161124"]}],"id":[{"id":"10.13039\/501100000291","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kidney Research Training Fellowship","award":["KKR\/Paed2017\/01"],"award-info":[{"award-number":["KKR\/Paed2017\/01"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["CDF-2016-09-038"],"award-info":[{"award-number":["CDF-2016-09-038"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Career Development Fellowship"},{"DOI":"10.13039\/100006662","name":"NIHR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Health Service"},{"name":"NIHR or the Department of Health and Social Care"},{"name":"Department of Health via the National Institute for Health Research comprehensive Biomedical Research Centre"},{"name":"Clinical Research Facilities"},{"name":"St Thomas\u2019 NHS Foundation Trust in partnership with King\u2019s College London and King\u2019s College Hospital NHS Foundation Trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. Biomarkers and dual-energy X-ray absorptiometry (DXA) are thought to be poor predictors of bone mineral density (BMD). The Kidney Disease: Improving Global Outcomes guidelines suggest using DXA if the results will affect patient management, but this has not been studied in children or young adults in whom bone mineral accretion continues to 30\u2009years of age. We studied the clinical utility of DXA and serum biomarkers against tibial cortical BMD (CortBMD) measured by peripheral quantitative computed tomography, expressed as Z-score CortBMD, which predicts fracture risk.<\/jats:p>\n               <jats:p>Methods. This was a cross-sectional multicentre study in 26 patients with CKD4 and 5 and 77 on dialysis.<\/jats:p>\n               <jats:p>Results. Significant bone pain that hindered activities of daily living was present in 58%, and 10% had at least one low-trauma fracture. CortBMD and cortical mineral content Z-scores were lower in dialysis compared with CKD patients (P\u2009=\u20090.004 and P\u2009=\u20090.02). DXA BMD hip and lumbar spine Z-scores did not correlate with CortBMD or biomarkers. CortBMD was negatively associated with parathyroid hormone (PTH; r\u2009=\u2009\u22120.44, P\u2009&amp;lt;\u20090.0001) and alkaline phosphatase (ALP; r\u2009=\u2009\u22120.22, P\u2009=\u20090.03) and positively with calcium (Ca; r\u2009=\u20090.33, P\u2009=\u20090.001). At PTH &amp;lt;3 times upper limit of normal, none of the patients had a CortBMD below \u22122 SD (odds ratio 95% confidence interval 7.331 to infinity). On multivariable linear regression PTH (\u03b2 = \u22120.43 , P\u2009&amp;lt;\u20090.0001), ALP (\u03b2 = \u22120.36, P\u2009&amp;lt;\u20090.0001) and Ca (\u03b2 = 0.21, P\u2009=\u20090.005) together predicted 57% of variability in CortBMD. DXA measures did not improve this model.<\/jats:p>\n               <jats:p>Conclusions. Taken together, routinely used biomarkers, PTH, ALP and Ca, but not DXA, are moderate predictors of cortical BMD. DXA is not clinically useful and should not be routinely performed in children and young adults with CKD 4\u20135D.<\/jats:p>","DOI":"10.1093\/ndt\/gfaa199","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T19:10:04Z","timestamp":1594149004000},"page":"1872-1881","source":"Crossref","is-referenced-by-count":23,"title":["Routine serum biomarkers, but not dual-energy X-ray absorptiometry, correlate with cortical bone mineral density in children and young adults with chronic kidney disease"],"prefix":"10.1093","volume":"36","author":[{"given":"Alexander D","family":"Lalayiannis","sequence":"first","affiliation":[{"name":"Great Ormond St Hospital for Children NHS Foundation Trust, University College London Institute of Child Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J","family":"Crabtree","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0577-7081","authenticated-orcid":false,"given":"Charles J","family":"Ferro","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varvara","family":"Askiti","sequence":"additional","affiliation":[{"name":"\u201cP. & A. Kyriakou\u201d Childrens\u2019 Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andromachi","family":"Mitsioni","sequence":"additional","affiliation":[{"name":"\u201cP. & A. Kyriakou\u201d Childrens\u2019 Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Biassoni","sequence":"additional","affiliation":[{"name":"Great Ormond St Hospital for Children NHS Foundation Trust, University College London Institute of Child Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrit","family":"Kaur","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7593-1203","authenticated-orcid":false,"given":"Manish D","family":"Sinha","sequence":"additional","affiliation":[{"name":"Evelina Children\u2019s Hospital, Guy\u2019s & St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neill D","family":"Duncan","sequence":"additional","affiliation":[{"name":"Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Popoola","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, George\u2019s University Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David V","family":"Milford","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Long","sequence":"additional","affiliation":[{"name":"Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary 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