{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:09:00Z","timestamp":1792382940906,"version":"4.4.0"},"reference-count":203,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Renal osteodystrophy (ROD) is a common complication of end-stage kidney disease that often starts early with loss of kidney function, and it is considered an integral part in management of patients with chronic kidney disease (CKD). Adynamic bone (ADB) is characterized by suppressed bone formation, low cellularity, and thin osteoid seams. There is accumulating evidence supporting increasing prevalence of ADB, particularly in early CKD. Contemporarily, it is not very clear whether it represents a true disease, an adaptive mechanism to prevent bone resorption, or just a transitional stage. Several co-players are incriminated in its pathogenesis, such as age, diabetes mellitus, malnutrition, uremic milieu, and iatrogenic factors. In the present review, we will discuss the up-to-date knowledge of the ADB and focus on its impact on bone health, fracture risk, vascular calcification, and long-term survival. Moreover, we will emphasize the proper preventive and management strategies of ADB that are pivotal issues in managing patients with CKD. It is still unclear whether ADB is always a pathologic condition or whether it can represent an adaptive process to suppress bone resorption and further bone loss. In this article, we tried to discuss this hard topic based on the available limited information in patients with CKD. More studies are needed to be able to clearly address this frequent ROD finding.<\/jats:p>","DOI":"10.3390\/jcm11237130","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T02:24:46Z","timestamp":1669861486000},"page":"7130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Is Adynamic Bone Always a Disease? Lessons from Patients with Chronic Kidney Disease"],"prefix":"10.3390","volume":"11","author":[{"given":"Eman","family":"Nagy","sequence":"first","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2636-0966","authenticated-orcid":false,"given":"Mahmoud M.","family":"Sobh","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1157-9770","authenticated-orcid":false,"given":"Mohamed","family":"Abdalbary","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherouk","family":"Elnagar","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabab","family":"Elrefaey","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimaa","family":"Shabaka","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Elshabrawy","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha","family":"Shemies","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Tawfik","sequence":"additional","affiliation":[{"name":"Mansoura Nephrology and Dialysis Unit, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e1ssia Gomes S.","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology, Federal University of Paran\u00e1, Curitiba 80060-00, PR, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-9227","authenticated-orcid":false,"given":"Fellype C.","family":"Barreto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Nephrology, Federal University of Paran\u00e1, Curitiba 80060-00, PR, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9072-5029","authenticated-orcid":false,"given":"Amr","family":"El-Husseini","sequence":"additional","affiliation":[{"name":"Division of Nephrology & Bone and Mineral Metabolism, University of Kentucky, Lexington, KY 40536-0298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1002\/jbmr.309","article-title":"Renal osteodystrophy in the first decade of the new millennium: Analysis of 630 bone biopsies in black and white patients","volume":"26","author":"Malluche","year":"2011","journal-title":"J. Bone Miner. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"422","DOI":"10.7326\/M17-2640","article-title":"Diagnosis, evaluation, prevention, and treatment of chronic kidney disease\u2013mineral and bone disorder: Synopsis of the kidney disease: Improving global outcomes 2017 clinical practice guideline update","volume":"168","author":"Ketteler","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1002\/jbmr.1805","article-title":"Standardized nomenclature, symbols, and units for bone histomorphometry: A 2012 update of the report of the ASBMR Histomorphometry Nomenclature Committee","volume":"28","author":"Dempster","year":"2013","journal-title":"J. Bone Miner. Res. Off. J. Am. Soc. Bone Miner. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1359\/jbmr.090735","article-title":"Coronary calcification is associated with lower bone formation rate in CKD patients not yet in dialysis treatment","volume":"25","author":"Tomiyama","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1097\/01.ASN.0000129337.50739.48","article-title":"Arterial calcifications and bone histomorphometry in end-stage renal disease","volume":"15","author":"London","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Hernandes, F.R., Canziani, M.E.F., Barreto, F.C., Santos, R.O., Moreira, V.d.M., Rochitte, C.E., and Carvalho, A.B. (2017). The shift from high to low turnover bone disease after parathyroidectomy is associated with the progression of vascular calcification in hemodialysis patients: A 12-month follow-up study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0174811"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1056\/NEJM198404263101704","article-title":"Aluminum intoxication from aluminum-containing phosphate binders in children with azotemia not undergoing dialysis","volume":"310","author":"Andreoli","year":"1984","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/S0140-6736(78)90191-5","article-title":"Osteomalacic dialysis osteodystrophy: Evidence for a water-borne aetiological agent, probably aluminium","volume":"311","author":"Ward","year":"1978","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1093\/oxfordjournals.ndt.a027404","article-title":"Renal bone disease in 76 patients with varying degrees of predialysis chronic renal failure: A cross-sectional study","volume":"11","author":"Coen","year":"1996","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1007\/s00198-005-1903-7","article-title":"In elderly men and women treated for osteoporosis a low creatinine clearance of< 65 ml\/min is a risk factor for falls and fractures","volume":"16","author":"Dukas","year":"2005","journal-title":"Osteoporos. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"235","DOI":"10.5414\/CNP65235","article-title":"Renal osteodystrophy: What\u2019s in a name? Presentation of a clinically useful new model to interpret bone histologic findings","volume":"65","author":"Malluche","year":"2006","journal-title":"Clin. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1038\/sj.ki.5000414","article-title":"Kidney disease: Improving global outcomes (KDIGO). Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"69","author":"Moe","year":"2006","journal-title":"Kidney Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1038\/ki.1993.350","article-title":"Correlation of bone histology with parathyroid hormone, vitamin D3, and radiology in end-stage renal disease","volume":"44","author":"Hutchison","year":"1993","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1038\/ki.1993.64","article-title":"The spectrum of bone disease in end-stage renal failure\u2014an evolving disorder","volume":"43","author":"Sherrard","year":"1993","journal-title":"Kidney Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.kint.2015.12.004","article-title":"Changing bone patterns with progression of chronic kidney disease","volume":"89","author":"Massy","year":"2016","journal-title":"Kidney Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1053\/j.ajkd.2015.06.023","article-title":"Diagnostic accuracy of bone turnover markers and bone histology in patients with CKD treated by dialysis","volume":"67","author":"Sprague","year":"2016","journal-title":"Am. J. Kidney Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1038\/sj.ki.5002769","article-title":"K\/DOQI-recommended intact PTH levels do not prevent low-turnover bone disease in hemodialysis patients","volume":"73","author":"Barreto","year":"2008","journal-title":"Kidney Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s40620-017-0397-7","article-title":"Adynamic bone disease is a predominant bone pattern in early stages of chronic kidney disease","volume":"30","author":"Massy","year":"2017","journal-title":"J. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"289","DOI":"10.5935\/0101-2800.20140042","article-title":"Association between indoxyl sulfate and bone histomorphometry in pre-dialysis chronic kidney disease patients","volume":"36","author":"Barreto","year":"2014","journal-title":"Braz. J. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.ekir.2022.02.022","article-title":"Low turnover renal osteodystrophy with abnormal bone quality and vascular calcification in patients with mild-to-moderate CKD","volume":"7","author":"Abdalbary","year":"2022","journal-title":"Kidney Int. Rep."},{"key":"ref_21","unstructured":"Amr El-Husseini, M.M.A., Issa, M., Winkler, M., Lima, F., Faugere, M., Srour, H., and Malluche, H.H. (2021). Progression of Renal Osteodystrophy and Vascular Calcifications in Patients with CKD Stage II-IV. Kidney Week 2021, ASN."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1038\/ki.1976.42","article-title":"Bone histology in incipient and advanced renal failure","volume":"9","author":"Malluche","year":"1976","journal-title":"Kidney Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/ndt\/9.5.517","article-title":"Adynamic bone disease with negative aluminium staining in predialysis patients: Prevalence and evolution after maintenance dialysis","volume":"9","author":"Hernandez","year":"1994","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1038\/ki.1995.201","article-title":"Bone disease in predialysis, hemodialysis, and CAPD patients: Evidence of a better bone response to PTH","volume":"47","author":"Torres","year":"1995","journal-title":"Kidney Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/ndt\/11.supp3.111","article-title":"Trends in renal osteodystrophy: A survey from 1983 to 1995 in a total of 2248 patients","volume":"11","author":"Malluche","year":"1996","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ara\u00fajo, S.M., Ambrosoni, P., Lob\u00e3o, R.R., Caorsi, H., Moys\u00e9s, R.M., Barreto, F.C., Olaizola, I., Cruz, E.A., Petraglia, A., and Dos Reis, L.M. (2003). The renal osteodystrophy pattern in Brazil and Uruguay: An overview. Kidney Int. Suppl., S54\u2013S56.","DOI":"10.1046\/j.1523-1755.63.s85.13.x"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1053\/j.ajkd.2008.06.024","article-title":"Association of changes in bone remodeling and coronary calcification in hemodialysis patients: A prospective study","volume":"52","author":"Barreto","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1590\/2175-8239-jbn-2019-0045","article-title":"Renal osteodystrophy and clinical outcomes: Data from the Brazilian Registry of Bone Biopsies\u2014REBRABO","volume":"42","author":"Carbonara","year":"2020","journal-title":"J. Bras. Nefrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1093\/ckj\/sfab081","article-title":"Sclerostin and DKK1 circulating levels associate with low bone turnover in patients with chronic kidney disease Stages 3 and 4","volume":"14","author":"Neto","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1053\/j.ajkd.2021.07.027","article-title":"Diagnostic Accuracy of Noninvasive Bone Turnover Markers in Renal Osteodystrophy","volume":"79","author":"Behets","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.bone.2015.06.010","article-title":"Indoxyl sulfate exacerbates low bone turnover induced by parathyroidectomy in young adult rats","volume":"79","author":"Hirata","year":"2015","journal-title":"Bone"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1093\/ndt\/gfr647","article-title":"Indoxyl sulphate inhibits osteoclast differentiation and function","volume":"27","author":"Mozar","year":"2012","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Shyu, J.F., Liu, W.C., Zheng, C.M., Fang, T.C., Hou, Y.C., Chang, C.T., Liao, T.Y., Chen, Y.C., and Lu, K.C. (2021). Toxic Effects of Indoxyl Sulfate on Osteoclastogenesis and Osteoblastogenesis. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222011265"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2420","DOI":"10.1093\/ndt\/14.10.2420","article-title":"Whole blood production of monocytic cytokines (IL-1beta, IL-6, TNF-alpha, sIL-6R, IL-1Ra) in haemodialysed patients","volume":"14","author":"Lorgeot","year":"1999","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/00041552-199707000-00005","article-title":"Role of cytokines in renal osteodystrophy","volume":"6","author":"Malluche","year":"1997","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1038\/ki.1996.343","article-title":"Bone resorption and mRNA expression of IL-6 and IL-6 receptor in patients with renal osteodystrophy","volume":"50","author":"Langub","year":"1996","journal-title":"Kidney Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1038\/sj.ki.5001666","article-title":"Reversal of adynamic bone disease by lowering of dialysate calcium","volume":"70","author":"Haris","year":"2006","journal-title":"Kidney Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/gye.17.1.19.29","article-title":"Evaluation of bone turnover in postmenopausal patients with type 2 diabetes mellitus using biochemical markers and bone mineral density measurements","volume":"17","author":"Akin","year":"2003","journal-title":"Gynecol. Endocrinol."},{"key":"ref_39","first-page":"135","article-title":"Adynamic bone disease\u2014bone and beyond","volume":"1","author":"Brandenburg","year":"2008","journal-title":"NDT Plus"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1146\/annurev.me.37.020186.000455","article-title":"Aluminum and renal osteodystrophy","volume":"37","author":"Nebeker","year":"1986","journal-title":"Annu. Rev. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1046\/j.1523-1755.1998.00080.x","article-title":"Hypokinetic azotemic osteodystrophy","volume":"54","author":"Cohen","year":"1998","journal-title":"Kidney Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.kint.2021.04.043","article-title":"Differentiating the causes of adynamic bone in advanced chronic kidney disease informs osteoporosis treatment","volume":"100","author":"Haarhaus","year":"2021","journal-title":"Kidney Int."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kakani, E., Sloan, D., Sawaya, B.P., El-Husseini, A., Malluche, H.H., and Rao, M. (2019). Long-term outcomes and management considerations after parathyroidectomy in the dialysis patient. Seminars in Dialysis, Wiley Online Library.","DOI":"10.1111\/sdi.12833"},{"key":"ref_44","first-page":"198","article-title":"Serum albumin levels, an additional factor implicated in hyperparathyroidism outcome in peritoneal dialysis: A prospective study with paired bone biopsies","volume":"22","author":"Bajo","year":"2006","journal-title":"Adv. Perit. Dial."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s00198-018-4774-4","article-title":"Association between malnutrition-inflammation score and risk of subsequent self-reported bone fractures in prevalent kidney transplant recipients","volume":"30","author":"Gaipov","year":"2019","journal-title":"Osteoporos. Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"832127","DOI":"10.1155\/2015\/832127","article-title":"Bone Loss Triggered by the Cytokine Network in Inflammatory Autoimmune Diseases","volume":"2015","author":"Amarasekara","year":"2015","journal-title":"J. Immunol. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1053\/j.jrn.2010.10.006","article-title":"Insights into nutritional and inflammatory aspects of low parathyroid hormone in dialysis patients","volume":"21","author":"Feroze","year":"2011","journal-title":"J. Ren. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1023\/A:1020146023812","article-title":"Interleukin-6 induced suppression of bovine parathyroid hormone secretion","volume":"19","author":"Carlstedt","year":"1999","journal-title":"Biosci. Rep."},{"key":"ref_49","first-page":"561A","article-title":"Risk factors for the development of parathyroid hormone deficiency in dialysis patients","volume":"9","author":"Akizawa","year":"1998","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1210\/edrv.23.3.0465","article-title":"Sex steroids and the construction and conservation of the adult skeleton","volume":"23","author":"Riggs","year":"2002","journal-title":"Endocr. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1053\/ajkd.1998.v32.pm9808140","article-title":"Mechanism of vitamin D action and its regulation","volume":"32","author":"Dusso","year":"1998","journal-title":"Am. J. Kidney Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1038\/ki.2008.60","article-title":"Adynamic bone in patients with chronic kidney disease","volume":"73","author":"Andress","year":"2008","journal-title":"Kidney Int."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"14130","DOI":"10.1074\/jbc.M410720200","article-title":"Nongenotropic, anti-apoptotic signaling of 1alpha,25(OH)2-vitamin D3 and analogs through the ligand binding domain of the vitamin D receptor in osteoblasts and osteocytes. Mediation by Src, phosphatidylinositol 3-, and JNK kinases","volume":"280","author":"Vertino","year":"2005","journal-title":"J. Biol. Chem."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e024067","DOI":"10.1136\/bmjopen-2018-024067","article-title":"Diabetes mellitus and the risk of fractures at specific sites: A meta-analysis","volume":"9","author":"Wang","year":"2019","journal-title":"BMJ Open"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"775","DOI":"10.2337\/diab.44.7.775","article-title":"Bone loss and bone turnover in diabetes","volume":"44","author":"Krakauer","year":"1995","journal-title":"Diabetes"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"R137","DOI":"10.1530\/EJE-16-0652","article-title":"Mechanisms in Endocrinology: Diabetes mellitus, a state of low bone turnover\u2014A systematic review and meta-analysis","volume":"176","author":"Hygum","year":"2017","journal-title":"Eur. J. Endocrinol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.bbrc.2015.02.091","article-title":"Effects of high glucose and advanced glycation end products on the expressions of sclerostin and RANKL as well as apoptosis in osteocyte-like MLO-Y4-A2 cells","volume":"461","author":"Tanaka","year":"2015","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"101","DOI":"10.5051\/jpis.2015.45.3.101","article-title":"Hyperglycemia increases the expression levels of sclerostin in a reactive oxygen species- and tumor necrosis factor-alpha-dependent manner","volume":"45","author":"Kang","year":"2015","journal-title":"J. Periodontal Implant Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.2337\/dc14-2989","article-title":"Sclerostin and Insulin Resistance in Prediabetes: Evidence of a Cross Talk Between Bone and Glucose Metabolism","volume":"38","author":"Daniele","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"453","DOI":"10.7150\/ijms.8172","article-title":"Increased levels of circulating advanced glycation end-products in menopausal women with osteoporosis","volume":"11","author":"Yang","year":"2014","journal-title":"Int. J. Med. Sci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"5691","DOI":"10.1074\/jbc.M610536200","article-title":"Non-enzymatic glycation of bone collagen modifies osteoclastic activity and differentiation","volume":"282","author":"Valcourt","year":"2007","journal-title":"J. Biol. Chem."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1038\/nrendo.2016.153","article-title":"Mechanisms of diabetes mellitus-induced bone fragility","volume":"13","author":"Napoli","year":"2017","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"4867","DOI":"10.1210\/jc.2002-021447","article-title":"Octreotide abolishes the acute decrease in bone turnover in response to oral glucose","volume":"88","author":"Clowes","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Pacheco-Pantoja, E.L., Ranganath, L.R., Gallagher, J.A., Wilson, P.J., and Fraser, W.D. (2011). Receptors and effects of gut hormones in three osteoblastic cell lines. BMC Physiol., 11.","DOI":"10.1186\/1472-6793-11-12"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1002\/jbmr.2361","article-title":"Relationship between pretreatment rate of bone loss and bone density response to once-yearly ZOL: HORIZON-PFT extension study","volume":"30","author":"Eastell","year":"2015","journal-title":"J. Bone Miner. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/jbmr.2702","article-title":"Adynamic bone decreases bone toughness during aging by affecting mineral and matrix","volume":"31","author":"Ng","year":"2016","journal-title":"J. Bone Miner. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e10182","DOI":"10.1002\/jbm4.10182","article-title":"Persistent Activation of Calcium-Sensing Receptor Suppresses Bone Turnover, Increases Microcracks, and Decreases Bone Strength","volume":"3","author":"Dong","year":"2019","journal-title":"JBMR Plus"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"239","DOI":"10.5414\/CN109144","article-title":"Urinary calcium excretion and bone turnover in osteoporotic patients","volume":"88","author":"Chakraborty","year":"2017","journal-title":"Clin. Nephrol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1038\/sj.ki.5000311","article-title":"Osteoporosis in hemodialysis patients revisited by bone histomorphometry: A new insight into an old problem","volume":"69","author":"Barreto","year":"2006","journal-title":"Kidney Int."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e2903","DOI":"10.1210\/clinem\/dgaa317","article-title":"Biomarkers of bone turnover identify subsets of chronic kidney disease patients at higher risk for fracture","volume":"105","author":"Katz","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.34067\/KID.0000772020","article-title":"Parathyroid Hormone Serum Levels and Mortality among Hemodialysis Patients in the Gulf Cooperation Council Countries: Results from the DOPPS (2012\u20132018)","volume":"1","author":"Bieber","year":"2020","journal-title":"Kidney360"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1681\/ASN.V12102131","article-title":"Association of elevated serum PO(4), Ca x PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients","volume":"12","author":"Ganesh","year":"2001","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"869330","DOI":"10.3389\/fendo.2022.869330","article-title":"Low Parathyroid Hormone Versus Secondary Hyperparathyroidism and Survival in Patients Undergoing Hemodialysis: A Propensity-Matched Analysis","volume":"13","author":"Guo","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3904\/kjim.2018.264","article-title":"Low parathyroid hormone level predicts infection-related mortality in incident dialysis patients: A prospective cohort study","volume":"35","author":"Hong","year":"2020","journal-title":"Korean J. Intern. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"c211","DOI":"10.1159\/000321642","article-title":"Association between very low PTH levels and poor survival rates in haemodialysis patients: Results from the French ARNOS cohort","volume":"118","author":"Jean","year":"2011","journal-title":"Nephron Clin. Pract."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1093\/ndt\/gfq304","article-title":"Calcium, phosphorus, PTH and death rates in a large sample of dialysis patients from Latin America. The CORES Study","volume":"26","author":"Guinsburg","year":"2011","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"98","DOI":"10.2215\/CJN.12941213","article-title":"Recent changes in therapeutic approaches and association with outcomes among patients with secondary hyperparathyroidism on chronic hemodialysis: The DOPPS study","volume":"10","author":"Tentori","year":"2015","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1038\/sj.ki.5001514","article-title":"Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients","volume":"70","author":"Kuwae","year":"2006","journal-title":"Kidney Int."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Bover, J., Ure\u00f1a, P., Brandenburg, V., Goldsmith, D., Ruiz, C., DaSilva, I., and Bosch, R.J. (2014). Adynamic bone disease: From bone to vessels in chronic kidney disease. Seminars in Nephrology, Elsevier.","DOI":"10.1016\/j.semnephrol.2014.09.008"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1161\/CIRCULATIONAHA.120.050686","article-title":"Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options","volume":"143","author":"Jankowski","year":"2021","journal-title":"Circulation"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s00223-013-9712-z","article-title":"Vascular calcification: An update on mechanisms and challenges in treatment","volume":"93","author":"Wu","year":"2013","journal-title":"Calcif. Tissue Int."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1038\/ki.1994.342","article-title":"Evidence for abnormal calcium homeostasis in patients with adynamic bone disease","volume":"46","author":"Kurz","year":"1994","journal-title":"Kidney Int."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1681\/ASN.2006050490","article-title":"Reversal of the adynamic bone disorder and decreased vascular calcification in chronic kidney disease by sevelamer carbonate therapy","volume":"18","author":"Mathew","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/sdi.12598","article-title":"Imaging in Chronic Kidney Disease-Metabolic Bone Disease","volume":"30","author":"Alexander","year":"2017","journal-title":"Semin. Dial."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1093\/ndt\/gfq491","article-title":"The link between bone and coronary calcifications in CKD-5 patients on haemodialysis","volume":"26","author":"Asci","year":"2011","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1038\/ki.2014.372","article-title":"Peritoneal dialysis per se is a risk factor for sclerostin-associated adynamic bone disease","volume":"87","author":"Barreto","year":"2015","journal-title":"Kidney Int."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Neto, R., Pereira, L., Magalhaes, J., Quelhas-Santos, J., and Frazao, J. (2021). Low bone turnover is associated with plain X-ray vascular calcification in predialysis patients. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0258284"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1053\/j.ajkd.2015.01.034","article-title":"Calciphylaxis: Risk factors, diagnosis, and treatment","volume":"66","author":"Nigwekar","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_89","first-page":"160","article-title":"Calcific uremic arteriolopathy in association with low turnover uremic bone disease","volume":"52","author":"Mawad","year":"1999","journal-title":"Clin. Nephrol."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Patecki, M., Lehmann, G., Brasen, J.H., Schmitz, J., Bertram, A., Berthold, L.D., Haller, H., and Gwinner, W. (2017). A case report of severe calciphylaxis\u2014suggested approach for diagnosis and treatment. BMC Nephrol., 18.","DOI":"10.1186\/s12882-017-0556-z"},{"key":"ref_91","first-page":"97","article-title":"Calciphylaxis associated with chronic kidney disease and low bone turnover: Management with recombinant human PTH-(1-34)","volume":"1","author":"Elder","year":"2008","journal-title":"NDT Plus"},{"key":"ref_92","first-page":"126","article-title":"Calcific uraemic arteriolopathy (calciphylaxis): Data from a large nationwide registry","volume":"32","author":"Brandenburg","year":"2017","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"877","DOI":"10.2215\/CJN.06550810","article-title":"Sclerostin and Dickkopf-1 in renal osteodystrophy","volume":"6","author":"Cejka","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.kint.2016.12.029","article-title":"The complexity of chronic kidney disease-mineral and bone disorder across stages of chronic kidney disease","volume":"91","author":"Graciolli","year":"2017","journal-title":"Kidney Int."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Brandenburg, V.M., Kramann, R., Koos, R., Kruger, T., Schurgers, L., Muhlenbruch, G., Hubner, S., Gladziwa, U., Drechsler, C., and Ketteler, M. (2013). Relationship between sclerostin and cardiovascular calcification in hemodialysis patients: A cross-sectional study. BMC Nephrol., 14.","DOI":"10.1186\/1471-2369-14-219"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1093\/ndt\/gfv081","article-title":"Osteoprotegerin and sclerostin in chronic kidney disease prior to dialysis: Potential partners in vascular calcifications","volume":"30","author":"Morena","year":"2015","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1002\/jbmr.4203","article-title":"Chronic Kidney Disease-Induced Vascular Calcification Impairs Bone Metabolism","volume":"36","author":"Mace","year":"2021","journal-title":"J. Bone Min. Res."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Mace, M.L., Egstrand, S., Morevati, M., Olgaard, K., and Lewin, E. (2021). New Insights to the Crosstalk between Vascular and Bone Tissue in Chronic Kidney Disease-Mineral and Bone Disorder. Metabolites, 11.","DOI":"10.3390\/metabo11120849"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Goncalves, F.L., Elias, R.M., dos Reis, L.M., Graciolli, F.G., Zampieri, F.G., Oliveira, R.B., Jorgetti, V., and Moyses, R.M. (2014). Serum sclerostin is an independent predictor of mortality in hemodialysis patients. BMC Nephrol., 15.","DOI":"10.1186\/1471-2369-15-190"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1159\/000443845","article-title":"High Serum Sclerostin Levels Are Associated with a Better Outcome in Haemodialysis Patients","volume":"132","author":"Jean","year":"2016","journal-title":"Nephron"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"547","DOI":"10.33549\/physiolres.934034","article-title":"Sclerostin levels predict cardiovascular mortality in long-term hemodialysis patients: A prospective observational cohort study","volume":"68","author":"Kalousova","year":"2019","journal-title":"Physiol. Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1093\/ndt\/gfu301","article-title":"High levels of circulating sclerostin are associated with better cardiovascular survival in incident dialysis patients: Results from the NECOSAD study","volume":"30","author":"Drechsler","year":"2015","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1080\/0886022X.2020.1741386","article-title":"Association of sclerostin with cardiovascular events and mortality in dialysis patients","volume":"42","author":"Zou","year":"2020","journal-title":"Ren. Fail."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/S8756-3282(02)00947-X","article-title":"Trabecular minimodeling in human iliac bone","volume":"32","author":"Kobayashi","year":"2003","journal-title":"Bone"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1111\/j.1523-1755.2005.00464.x","article-title":"Significance of minimodeling in dialysis patients with adynamic bone disease","volume":"68","author":"Ubara","year":"2005","journal-title":"Kidney Int."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1046\/j.1523-1755.2003.00916.x","article-title":"Histomorphometric features of bone in patients with primary and secondary hypoparathyroidism","volume":"63","author":"Ubara","year":"2003","journal-title":"Kidney Int."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1093\/ndt\/17.4.620","article-title":"Parathyroid hormone-independent osteoclastic resorptive bone disease: A new variant of adynamic bone disease in haemodialysis patients","volume":"17","author":"Popovtzer","year":"2002","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1053\/j.ajkd.2006.05.028","article-title":"Variant of adynamic bone disease in hemodialysis patients: Fact or fiction?","volume":"48","author":"Rocha","year":"2006","journal-title":"Am. J. Kidney Dis."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1002\/jbm4.10117","article-title":"Rethinking Bone Disease in Kidney Disease","volume":"2","author":"Damasiewicz","year":"2018","journal-title":"JBMR Plus"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1681\/ASN.V73506","article-title":"Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients","volume":"7","author":"Hruby","year":"1996","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.2215\/CJN.01770408","article-title":"Relationship between bone histology and markers of bone and mineral metabolism in African-American hemodialysis patients","volume":"4","author":"Moore","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s40620-017-0408-8","article-title":"Circulating markers of bone turnover","volume":"30","author":"Vervloet","year":"2017","journal-title":"J. Nephrol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/S2213-8587(17)30184-5","article-title":"Use of bone turnover markers in postmenopausal osteoporosis","volume":"5","author":"Eastell","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.semnephrol.2014.09.006","article-title":"News on biomarkers in CKD-MBD","volume":"34","author":"Mazzaferro","year":"2014","journal-title":"Semin. Nephrol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s00774-003-0476-9","article-title":"Effect of hemodialysis and renal failure on serum biochemical markers of bone turnover","volume":"22","author":"Alvarez","year":"2004","journal-title":"J. Bone Min. Metab."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1046\/j.1523-1755.1999.00461.x","article-title":"Circulating biochemical markers of bone remodeling in uremic patients","volume":"55","year":"1999","journal-title":"Kidney Int."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1053\/snep.2002.35965","article-title":"Renal osteodystrophy in chronic renal failure","volume":"22","author":"Ho","year":"2002","journal-title":"Semin. Nephrol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1159\/000168453","article-title":"Procollagen type I C-terminal extension peptide in predialysis chronic renal failure","volume":"12","author":"Coen","year":"1992","journal-title":"Am. J. Nephrol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1002\/jbmr.1916","article-title":"Rapid cortical bone loss in patients with chronic kidney disease","volume":"28","author":"Nickolas","year":"2013","journal-title":"J. Bone Min. Res."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Kuo, T.H., Lin, W.H., Chao, J.Y., Wu, A.B., Tseng, C.C., Chang, Y.T., Liou, H.H., and Wang, M.C. (2019). Serum sclerostin levels are positively related to bone mineral density in peritoneal dialysis patients: A cross-sectional study. BMC Nephrol., 20.","DOI":"10.1186\/s12882-019-1452-5"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"4315","DOI":"10.1210\/jc.2014-2372","article-title":"Relationship between serum sclerostin, bone metabolism markers, and bone mineral density in maintenance hemodialysis patients","volume":"99","author":"Ishimura","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1002\/jbmr.4636","article-title":"Evaluation of Renal Osteodystrophy and Serum Bone-Related Biomarkers in a Peritoneal Dialysis Population","volume":"37","author":"Pereira","year":"2022","journal-title":"J. Bone Min. Res."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s11914-017-0362-3","article-title":"Biomarkers Predicting Bone Turnover in the Setting of CKD","volume":"15","author":"Evenepoel","year":"2017","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1007\/s00223-008-9127-4","article-title":"Serum levels of TRAP5b, a new bone resorption marker unaffected by renal dysfunction, as a useful marker of cortical bone loss in hemodialysis patients","volume":"82","author":"Shidara","year":"2008","journal-title":"Calcif. Tissue Int."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s00198-006-0286-8","article-title":"Assessment of osteoclast number and function: Application in the development of new and improved treatment modalities for bone diseases","volume":"18","author":"Henriksen","year":"2007","journal-title":"Osteoporos. Int."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1530\/JOE-12-0143","article-title":"The importance of the SIBLING family of proteins on skeletal mineralisation and bone remodelling","volume":"214","author":"Staines","year":"2012","journal-title":"J. Endocrinol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"87","DOI":"10.2119\/molmed.2014.00211","article-title":"Sirtuin 1: A Target for Kidney Diseases","volume":"21","author":"Kong","year":"2015","journal-title":"Mol. Med."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000515534","article-title":"Bone Quality in CKD Patients: Current Concepts and Future Directions\u2014Part I","volume":"7","author":"Asadipooya","year":"2021","journal-title":"Kidney Dis."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s00223-021-00874-9","article-title":"Bone Histomorphometry and (18)F-Sodium Fluoride Positron Emission Tomography Imaging: Comparison Between only Bone Turnover-based and Unified TMV-based Classification of Renal Osteodystrophy","volume":"109","author":"Aaltonen","year":"2021","journal-title":"Calcif. Tissue Int."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"6508","DOI":"10.1210\/jc.2005-1258","article-title":"In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography","volume":"90","author":"Boutroy","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1080\/0886022X.2022.2043375","article-title":"Comparison of bone microstructures via high-resolution peripheral quantitative computed tomography in patients with different stages of chronic kidney disease before and after starting hemodialysis","volume":"44","author":"Tsuji","year":"2022","journal-title":"Ren. Fail."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.2215\/CJN.09711010","article-title":"Bone microarchitecture in hemodialysis patients assessed by HR-pQCT","volume":"6","author":"Cejka","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1053\/snuc.2001.18742","article-title":"Quantitative studies of bone with the use of 18F-fluoride and 99mTc-methylene diphosphonate","volume":"31","author":"Blake","year":"2001","journal-title":"Semin. Nucl. Med."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"115267","DOI":"10.1016\/j.bone.2020.115267","article-title":"Correlation between (18)F-Sodium Fluoride positron emission tomography and bone histomorphometry in dialysis patients","volume":"134","author":"Aaltonen","year":"2020","journal-title":"Bone"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.bone.2018.05.029","article-title":"Magnetic resonance imaging based assessment of bone microstructure as a non-invasive alternative to histomorphometry in patients with chronic kidney disease","volume":"114","author":"Sharma","year":"2018","journal-title":"Bone"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.kint.2017.04.006","article-title":"Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: What\u2019s changed and why it matters","volume":"92","author":"Ketteler","year":"2017","journal-title":"Kidney Int."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1002\/jbmr.5650020617","article-title":"Bone histomorphometry: Standardization of nomenclature, symbols, and units. Report of the ASBMR Histomorphometry Nomenclature Committee","volume":"2","author":"Parfitt","year":"1987","journal-title":"J. Bone Min. Res."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/sdi.12236","article-title":"What is the role of bone biopsy in the management of adult dialysis patients?","volume":"27","author":"Sawaya","year":"2014","journal-title":"Semin. Dial."},{"key":"ref_139","first-page":"196","article-title":"Bone matrix mineralization and osteocyte lacunae characteristics in patients with chronic kidney disease\u2014mineral bone disorder (CKD-MBD)","volume":"19","author":"Misof","year":"2019","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_140","first-page":"1608","article-title":"Bone biopsy practice patterns across Europe: The European renal osteodystrophy initiative-a position paper","volume":"32","author":"Evenepoel","year":"2017","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.kint.2022.04.030","article-title":"Bone histomorphometry for the diagnosis of renal osteodystrophy: A call for harmonization of reference ranges","volume":"102","author":"Ferreira","year":"2022","journal-title":"Kidney Int."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1038\/nrneph.2013.198","article-title":"Evaluating bone quality in patients with chronic kidney disease","volume":"9","author":"Malluche","year":"2013","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"481","DOI":"10.2215\/CJN.04810515","article-title":"Micro-CT in the Assessment of Pediatric Renal Osteodystrophy by Bone Histomorphometry","volume":"11","author":"Pereira","year":"2016","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_144","unstructured":"Amr El-Husseini, F.L., Meulendyke, K., Abdalbary, M., Nagy, E., Srour, H., Faugere, M., and Malluche, H. (2022). Changes in Bone Quality Over Two Years in Patients with CKD II-IV. Kidney Week 2022, ASN."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1002\/jbmr.3676","article-title":"Effects of Denosumab and Alendronate on Bone Health and Vascular Function in Hemodialysis Patients: A Randomized, Controlled Trial","volume":"34","author":"Iseri","year":"2019","journal-title":"J. Bone Min. Res."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/j.ajkd.2005.04.035","article-title":"Changes in cardiovascular calcification after parathyroidectomy in patients with ESRD","volume":"46","author":"Bleyer","year":"2005","journal-title":"Am. J. Kidney Dis."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.clnu.2018.12.022","article-title":"ESPEN guideline on clinical nutrition in liver disease","volume":"38","author":"Plauth","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1038\/ki.2008.407","article-title":"Cinacalcet suppresses calcification of the aorta and heart in uremic rats","volume":"74","author":"Kawata","year":"2008","journal-title":"Kidney Int."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.kint.2018.12.015","article-title":"Calcimimetics maintain bone turnover in uremic rats despite the concomitant decrease in parathyroid hormone concentration","volume":"95","author":"Pineda","year":"2019","journal-title":"Kidney Int."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/ki.2008.242","article-title":"Bone formation by minimodeling is more active than remodeling after parathyroidectomy","volume":"74","author":"Yajima","year":"2008","journal-title":"Kidney Int."},{"key":"ref_151","doi-asserted-by":"crossref","unstructured":"Lu, C.L., Shyu, J.F., Wu, C.C., Hung, C.F., Liao, M.T., Liu, W.C., Zheng, C.M., Hou, Y.C., Lin, Y.F., and Lu, K.C. (2018). Association of Anabolic Effect of Calcitriol with Osteoclast-Derived Wnt 10b Secretion. Nutrients, 10.","DOI":"10.3390\/nu10091164"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/(SICI)1097-0185(199712)249:4<458::AID-AR5>3.0.CO;2-N","article-title":"Effects of short-term treatment with the bisphosphonates zoledronate and pamidronate on rat bone: A comparative histomorphometric study on the cancellous bone formed before, during, and after treatment","volume":"249","author":"Pataki","year":"1997","journal-title":"Anat. Rec."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1007\/s11914-016-0329-9","article-title":"Effects of Type 1 Diabetes on Osteoblasts, Osteocytes, and Osteoclasts","volume":"14","author":"Kalaitzoglou","year":"2016","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s13098-017-0278-1","article-title":"The impact of type 2 diabetes on bone metabolism","volume":"9","author":"Sanches","year":"2017","journal-title":"Diabetol. Metab. Synd."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.bone.2007.10.010","article-title":"Decreased bone turnover with balanced resorption and formation prevent cortical bone loss during disuse (hibernation) in grizzly bears (Ursus arctos horribilis)","volume":"42","author":"McGee","year":"2008","journal-title":"Bone"},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1016\/j.bone.2009.08.011","article-title":"Grizzly bears (Ursus arctos horribilis) and black bears (Ursus americanus) prevent trabecular bone loss during disuse (hibernation)","volume":"45","author":"Wojda","year":"2009","journal-title":"Bone"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1242\/jeb.120725","article-title":"Suppressed bone remodeling in black bears conserves energy and bone mass during hibernation","volume":"218","author":"Buckendahl","year":"2015","journal-title":"J. Exp. Biol."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1093\/ndt\/gfaa192","article-title":"European Consensus Statement on the diagnosis and management of osteoporosis in chronic kidney disease stages G4-G5D","volume":"36","author":"Evenepoel","year":"2021","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/j.kint.2021.09.011","article-title":"Antiresorptives in patients with chronic kidney disease with adynamic bone: Is absence of evidence of harm equal to no harm?","volume":"100","author":"Sobh","year":"2021","journal-title":"Kidney Int."},{"key":"ref_160","first-page":"32","article-title":"Management of adynamic bone disease in chronic kidney disease: A brief review","volume":"5","author":"Sista","year":"2016","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1038\/ki.1994.380","article-title":"Development of adynamic bone in patients with secondary hyperparathyroidism after intermittent calcitriol therapy","volume":"46","author":"Goodman","year":"1994","journal-title":"Kidney Int."},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1046\/j.1523-1755.2002.00450.x","article-title":"Update on vitamin D and its newer analogues: Actions and rationale for treatment in chronic renal failure","volume":"62","author":"Malluche","year":"2002","journal-title":"Kidney Int."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1159\/000188716","article-title":"Studies in a hemodialysis patient indicating that calcitriol may have a direct suppressive effect on bone","volume":"71","author":"Pahl","year":"1995","journal-title":"Nephron"},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.2215\/CJN.03461006","article-title":"Opposite effects of calcitriol and paricalcitol on the parathyroid hormone-(1-84)\/large carboxy-terminal-parathyroid hormone fragments ratio in patients with stage 5 chronic kidney disease","volume":"2","author":"Mawad","year":"2007","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1038\/ki.2011.226","article-title":"No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: A randomized crossover trial","volume":"80","author":"Hansen","year":"2011","journal-title":"Kidney Int."},{"key":"ref_166","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group (2017). KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl. (2011), 7, 1\u201359.","DOI":"10.1016\/j.kisu.2017.04.001"},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1016\/j.kint.2016.06.041","article-title":"Parathyroid hormone metabolism and signaling in health and chronic kidney disease","volume":"90","author":"Evenepoel","year":"2016","journal-title":"Kidney Int."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1053\/j.ajkd.2020.05.006","article-title":"KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update","volume":"76","author":"Ikizler","year":"2020","journal-title":"Am. J. Kidney Dis."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1681\/ASN.2006101089","article-title":"Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients","volume":"19","author":"Ferreira","year":"2008","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.3109\/0886022X.2014.938544","article-title":"The effects of non-calcium-based phosphate binders versus calcium-based phosphate binders on cardiovascular calcification and bone remodeling among dialysis patients: A meta-analysis of randomized trials","volume":"36","author":"Liu","year":"2014","journal-title":"Ren. Fail."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3747\/pdi.2013.00177","article-title":"Calcium balance and negative impact of calcium load in peritoneal dialysis patients","volume":"34","author":"Wang","year":"2014","journal-title":"Perit. Dial. Int."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5414\/CNP67020","article-title":"Low-calcium dialysate improves mineral metabolism in hemodialysis patients","volume":"67","author":"Fujimori","year":"2007","journal-title":"Clin. Nephrol."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1744-9987.2007.00419.x","article-title":"Effects of lowering dialysate calcium concentration on mineral metabolism and parathyroid hormone secretion: A multicentric study","volume":"11","author":"Lezaic","year":"2007","journal-title":"Apher. Dial."},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.bone.2007.06.014","article-title":"Improvement of bone and mineral parameters related to adynamic bone disease by diminishing dialysate calcium","volume":"41","author":"Spasovski","year":"2007","journal-title":"Bone"},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"115518","DOI":"10.1016\/j.bone.2020.115518","article-title":"Fifty years of bisphosphonates: What are their mechanical effects on bone?","volume":"138","author":"Burr","year":"2020","journal-title":"Bone"},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S2213-8587(17)30138-9","article-title":"10 years of denosumab treatment in postmenopausal women with osteoporosis: Results from the phase 3 randomised FREEDOM trial and open-label extension","volume":"5","author":"Bone","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1210\/jc.2017-02669","article-title":"Effects of Long-Term Denosumab on Bone Histomorphometry and Mineralization in Women With Postmenopausal Osteoporosis","volume":"103","author":"Dempster","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1359\/jbmr.070112","article-title":"Alendronate treatment in women with normal to severely impaired renal function: An analysis of the fracture intervention trial","volume":"22","author":"Jamal","year":"2007","journal-title":"J. Bone Min. Res."},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jbspin.2019.07.010","article-title":"Rebound-associated vertebral fractures after stopping denosumab: Report of four cases","volume":"87","author":"Dupont","year":"2020","journal-title":"Jt. Bone Spine"},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s13256-020-02401-0","article-title":"Long-term follow up after denosumab treatment for osteoporosis\u2014rebound associated with hypercalcemia, parathyroid hyperplasia, severe bone mineral density loss, and multiple fractures: A case report","volume":"14","author":"Maugars","year":"2020","journal-title":"J. Med. Case Rep."},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1002\/jbmr.4335","article-title":"Fractures After Denosumab Discontinuation: A Retrospective Study of 797 Cases","volume":"36","author":"Burckhardt","year":"2021","journal-title":"J. Bone Min. Res."},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s11657-019-0676-0","article-title":"Second rebound-associated vertebral fractures after denosumab discontinuation","volume":"15","author":"Niimi","year":"2020","journal-title":"Arch. Osteoporos."},{"key":"ref_183","doi-asserted-by":"crossref","unstructured":"Anastasilakis, A.D., Makras, P., Yavropoulou, M.P., Tabacco, G., Naciu, A.M., and Palermo, A. (2021). Denosumab Discontinuation and the Rebound Phenomenon: A Narrative Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10010152"},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/jbmr.3337","article-title":"Vertebral Fractures After Discontinuation of Denosumab: A Post Hoc Analysis of the Randomized Placebo-Controlled FREEDOM Trial and Its Extension","volume":"33","author":"Cummings","year":"2018","journal-title":"J. Bone Min. Res."},{"key":"ref_185","doi-asserted-by":"crossref","first-page":"100562","DOI":"10.1016\/j.bonr.2020.100562","article-title":"Severe rebound effect and multiple fractures after denosumab discontinuation in patient with chronic kidney disease stage 5","volume":"13","author":"Mazurenko","year":"2020","journal-title":"Bone Rep."},{"key":"ref_186","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/j.kint.2017.07.021","article-title":"Fractures in patients with CKD-diagnosis, treatment, and prevention: A review by members of the European Calcified Tissue Society and the European Renal Association of Nephrology Dialysis and Transplantation","volume":"92","author":"Pimentel","year":"2017","journal-title":"Kidney Int."},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.metabol.2009.08.007","article-title":"Obesity is associated with increased parathyroid hormone levels independent of glomerular filtration rate in chronic kidney disease","volume":"59","author":"Saab","year":"2010","journal-title":"Metabolism"},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1093\/ndt\/gfl311","article-title":"Administration of oral charcoal adsorbent (AST-120) suppresses low-turnover bone progression in uraemic rats","volume":"21","author":"Iwasaki","year":"2006","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_189","doi-asserted-by":"crossref","unstructured":"Maheshwari, V., Tao, X., Thijssen, S., and Kotanko, P. (2021). Removal of Protein-Bound Uremic Toxins Using Binding Competitors in Hemodialysis: A Narrative Review. Toxins, 13.","DOI":"10.3390\/toxins13090622"},{"key":"ref_190","doi-asserted-by":"crossref","first-page":"962","DOI":"10.2215\/CJN.11031017","article-title":"Management of Osteoporosis in CKD","volume":"13","author":"Khairallah","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"822178","DOI":"10.3389\/fphar.2022.822178","article-title":"Efficacy of Osteoporosis Medications for Patients With Chronic Kidney Disease: An Updated Systematic Review and Network Meta-Analysis","volume":"13","author":"Chen","year":"2022","journal-title":"Front. Pharm."},{"key":"ref_192","doi-asserted-by":"crossref","first-page":"5013","DOI":"10.1007\/s12325-022-02292-1","article-title":"Five-Year Estimated Glomerular Filtration Rate in Adults with Chronic Hypoparathyroidism Treated with rhPTH(1-84): A Retrospective Cohort Study","volume":"39","author":"Ayodele","year":"2022","journal-title":"Adv. Ther."},{"key":"ref_193","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.bone.2011.10.018","article-title":"Teriparatide and the risk of nonvertebral fractures in women with postmenopausal osteoporosis","volume":"50","author":"Krege","year":"2012","journal-title":"Bone"},{"key":"ref_194","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1080\/03007995.2019.1656955","article-title":"Abaloparatide in patients with mild or moderate renal impairment: Results from the ACTIVE phase 3 trial","volume":"35","author":"Bilezikian","year":"2019","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1001\/jama.2016.11136","article-title":"Effect of Abaloparatide vs Placebo on New Vertebral Fractures in Postmenopausal Women With Osteoporosis: A Randomized Clinical Trial","volume":"316","author":"Miller","year":"2016","journal-title":"JAMA"},{"key":"ref_196","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1056\/NEJMoa1708322","article-title":"Romosozumab or Alendronate for Fracture Prevention in Women with Osteoporosis","volume":"377","author":"Saag","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_197","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1002\/jbmr.4563","article-title":"Efficacy and Safety of Romosozumab Among Postmenopausal Women With Osteoporosis and Mild-to-Moderate Chronic Kidney Disease","volume":"37","author":"Miller","year":"2022","journal-title":"J. Bone Min. Res."},{"key":"ref_198","doi-asserted-by":"crossref","unstructured":"Saito, T., Mizobuchi, M., Kato, T., Suzuki, T., Fujiwara, Y., Kanamori, N., Makuuchi, M., and Honda, H. (2022). One-Year Romosozumab Treatment Followed by One-Year Denosumab Treatment for Osteoporosis in Patients on Hemodialysis: An Observational Study. Calcif. Tissue Int., online ahead of print.","DOI":"10.1007\/s00223-022-01031-6"},{"key":"ref_199","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1007\/s00774-021-01253-y","article-title":"Efficacy of romosozumab in patients with osteoporosis on maintenance hemodialysis in Japan; an observational study","volume":"39","author":"Sato","year":"2021","journal-title":"J. Bone Min. Metab."},{"key":"ref_200","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000341864","article-title":"Impact of long-term cinacalcet, ibandronate or teriparatide therapy on bone mineral density of hemodialysis patients: A pilot study","volume":"36","author":"Mitsopoulos","year":"2012","journal-title":"Am. J. Nephrol."},{"key":"ref_201","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1159\/000316708","article-title":"Treatment of Hemodialysis-Associated Adynamic Bone Disease with Teriparatide (PTH1-34): A Pilot Study","volume":"33","author":"Cejka","year":"2010","journal-title":"Kidney Blood Press Res."},{"key":"ref_202","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1007\/s00198-015-3377-6","article-title":"Once-weekly teriparatide in hemodialysis patients with hypoparathyroidism and low bone mass: A prospective study","volume":"27","author":"Sumida","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_203","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1002\/jbmr.554","article-title":"Ronacaleret, a calcium-sensing receptor antagonist, increases trabecular but not cortical bone in postmenopausal women","volume":"27","author":"Fitzpatrick","year":"2012","journal-title":"J. Bone Min. Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/23\/7130\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:30:43Z","timestamp":1760146243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/23\/7130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":203,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11237130"],"URL":"https:\/\/doi.org\/10.3390\/jcm11237130","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,30]]}}}