The impact of nephrectomy on bone health

Abstract

Normal kidneys function plays a crucial role in maintaining bone health. This fact is highlighted by the mineral-bone disorder resulting from chronic kidney disease (CKD). CKD impairs the skeletal structure, which in turn leads to a higher prevalence of bone fractures. Because nephrectomy results in a reduced number of nephrons, the question arises if surgically induced nephron loss causes alterations in bone health similar to those observed in CKD. A large number of studies draw attention to the fact that nephrectomy leads to mineral disturbances. Recent studies are consistent that nephrectomy leads to a decline in phosphate and calcitriol levels and an increase in parathyroid hormone levels. There is no consensus regarding the impact of surgically induced nephron loss on fibroblast growth factor 23 (FGF-23) levels. Whether the observed alterations translate into increased fractures rate is still unclear. Current data is sparse and further studies are required to evaluate the possible adverse impact of nephrectomy on bone health. This is a review of the literature exploring the impact of nephrectomy on mineral disturbances and bone health.