Chapter

Osteocytes and mineral metabolism

Susan C. Schiavi and Jian Q. Feng

in The Spectrum of Mineral and Bone Disorders in Chronic Kidney Disease

Second edition

Published on behalf of Oxford University Press

Published in print June 2010 | ISBN: 9780199559176
Published online November 2012 | e-ISBN: 9780191753350 | DOI: http://dx.doi.org/10.1093/med/9780199559176.003.003

Series: Oxford Clinical Nephrology Series

Osteocytes and mineral metabolism

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Emerging data incorporating genetic models and specialized microscopy techniques have established a new paradigm in which the osteocyte plays an active, rather than passive role in the mineralization process. Additionally, it is now recognized that the osteocyte also co-ordinates mineralization with systemic phosphate regulation through its expression of multi-functional proteins that simultaneously regulate mineralization and production of the phosphaturic hormone, FGF23. Thus, DMP1, a matrix protein that has a positive influence on mineralization, is a negative regulator of FGF23, whereas MEPE, a protein that is associated with reduced mineralization, appears to enhance FGF23 expression. It is currently unclear whether FGF23 expression is more tightly controlled by the extent of mineralization or the stage of osteocyte maturation. Furthermore, conflicting information exists regarding potential local effects of FGF23 during normal and abnormal states of bone remodeling. FGF23 elevations in CKD have illuminated the potential contributions of the osteocyte in renal osteodystrophy and raised new questions regarding the role of FGF23 in the mineralization process. Analysis of the physical attributes of osteocyte lacunocanalicular systems in conjunction with the parameters outlined by KDIGO will assist in defining the extent in which variations of osteocyte functions may contribute to the spectrum of renal osteodystrophy.

Chapter.  5779 words.  Illustrated.

Subjects: Rheumatology ; Nephrology

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