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The bone and beyond

'Dem bones' are made for more than walking

Bone is an endocrine organ that reaches out to other tissues, orchestrating responses that may have a role in pathology and physiology at distant sites. In 'Bench to Bedside', L. Darryl Quarles discusses recent studies showing how a feedback loop between the bone hormone FGF-23 and renal phosphate excretion and vitamin D metabolism is integrated with the classical PTH–vitamin D axis in chronic kidney disease (CKD). This new paradigm may change the diagnosis and treatment of disordered mineral homeostasis of people with CKD. A recent epidemiological study argues a mechanistic link between bone loss and atherosclerosis, maladies usually linked to aging. In 'Bedside to Bench', Sundeep Khosla discusses how this clinical study underpins research showing that mediators of inflammation and oxidative stress share common mechanisms that may lead to this calcium shift during aging.

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Figure 1: Abnormalities in the FGF-23–parathyroid hormone–vitamin D endocrine network in CKD.

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Correspondence to L Darryl Quarles.

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L.D.C. is a consultant to Amgen, KAI Pharmaceuticals and Shire. He has also been a paid speaker for Amgen.

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Quarles, L. 'Dem bones' are made for more than walking. Nat Med 17, 428–430 (2011). https://doi.org/10.1038/nm0411-428

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