Pleiotropic Endocrine Functions of Bone in Chronic Kidney Disease

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ID: 333805
2026
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Abstract
Abstract The principal organs involved in the control of mineral homeostasis are the kidneys, parathyroid glands, intestine and bone, which interact in a finely coordinated manner to maintain calcium and phosphorus levels. Mineral balance is disrupted in the context of chronic kidney disease (CKD), triggering compensatory mechanisms that paradoxically lead to a cascade of systemic complications that affect numerous organs. Among these organs, bone has increasingly been recognized as an endocrine organ, highlighting the role of bone-derived hormones in CKD complications beyond mineral metabolism. Osteocytes play a key role in the regulation of phosphorus metabolism, mediated by Fibroblast Growth Factor 23 (FGF23), which also demonstrates pleiotropic effects. Furthermore, bone cells produce a wide range of proteins that participate in the regulation of diverse systemic functions, such as glucose metabolism, male fertility, cognitive function, inflammation, appetite and hematopoiesis, which are processes commonly impaired in patients with CKD. So far, the systemic impact of dysregulated bone homeostasis in CKD has not been addressed in detail beyond its role in calcium-phosphate metabolism. This review aims to provide an overview of the role of bone as a main endocrine organ and its potential roles in organ dysfunction in CKD.
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openalex_W7223444236 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Juan Miguel Díaz‐Tocados, Juan Diego Domínguez-Coral, Martin H. de Borst, Mathias Loberg Haarhaus, Mehmet Kanbay, Ditte Hansen, Maria Fusaro, José Manuel Valdivielso, Antonio Bellasi
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag373
URL
https://doi.org/10.1093/ckj/sfag373
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