{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:39:51Z","timestamp":1764290391271,"version":"3.46.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","award":["RatchadapisekResearchFunds(CU_GR_63_96_30_03)"],"award-info":[{"award-number":["RatchadapisekResearchFunds(CU_GR_63_96_30_03)"]}],"id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100032355","name":"Kidney Foundation of Thailand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100032355","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      Chronic kidney disease\u2013mineral and bone disorder (CKD\u2013MBD) contributes to skeletal fragility through abnormalities in bone turnover. This study evaluated turnover\u2010guided therapy using bone histomorphometry and\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010NaF PET\/CT in haemodialysis patients with low bone mineral density (BMD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adult haemodialysis patients at a single centre (2018\u20132024) underwent turnover assessment by bone biopsy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931) or PET\/CT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927). Patients were grouped according to whether treatment followed an institutional turnover\u2010guided protocol introduced in 2020. Outcomes included changes in BMD, bone turnover markers (BTMs), and PET\u2010derived Ki values. For the biopsy cohort, multiple linear regression assessed treatment effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the biopsy cohort, protocol\u2010consistent treatment preserved distal radius BMD compared with historical controls. The annualised difference was +2.06% (95% CI 0.74\u20133.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) unadjusted and +2.38% (95% CI 0.24\u20134.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033) adjusted. No significant effects were seen at spine, hip, or femoral neck. BTMs decreased in protocol\u2010treated patients (B\u2010ALP \u201332.2%, TRACP5b \u221248.1%), while controls showed no significant change. In the PET\/CT cohort, high\u2010turnover patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) showed reductions in Ki at the iliac crest (\u221217.1%) and lumbar spine (\u221214.4%), alongside decreases in BTMs (B\u2010ALP \u201322.6%, TRACP5b \u221240.0%). Distal radius BMD improved at 1\u2009year in patients whose turnover normalised (+2.1% vs. \u22122.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Turnover\u2010guided treatment was associated with improvements in BMD, BTMs, and PET\u2010derived metabolic activity. These findings suggest the potential utility of turnover\u2010informed therapy in CKD\u2013MBD and support\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010NaF PET\/CT as a non\u2010invasive alternative to biopsy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70151","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T01:22:29Z","timestamp":1763947349000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone Turnover\u2013Guided Treatment of Low Bone Density in Haemodialysis Patients Using Bone Biopsy and Fluoride Positron Emission Tomography Imaging"],"prefix":"10.1111","volume":"30","author":[{"given":"Jeerath","family":"Phannajit","sequence":"first","affiliation":[{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Division of Clinical Epidemiology, Department of Medicine King Chulalongkorn Memorial Hospital, Thai Red Cross  Bangkok Thailand"},{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kitiwat","family":"Khamwan","sequence":"additional","affiliation":[{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Biomedical Imaging Group, Department of Radiology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4654-4030","authenticated-orcid":false,"given":"Viyada","family":"Sanoesan","sequence":"additional","affiliation":[{"name":"Division of Radiological Technology, Faculty of Science Ramkhamhaeng University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pobe","family":"Luangjarmekorn","sequence":"additional","affiliation":[{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saran","family":"Tantavisut","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Hip Fracture Research Unit, Department of Orthopaedics, Faculty of Medicine Chulalongkorn University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanatorn","family":"Khotavivattana","sequence":"additional","affiliation":[{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Center of Excellence in Natural Products, Department of Chemistry, Faculty of Science Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suthanit","family":"Laowalert","sequence":"additional","affiliation":[{"name":"Kidney Disease and Transplantation Institute, Praram 9 Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalita","family":"Wattanachanya","sequence":"additional","affiliation":[{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Division of 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