Figure 2.

Changes in bone material properties in uremic condition. Bone matrix has a structure in which type-I collagen fibers connected with crosslinks fibers form the main framework to which matrix protein and mineral crystals attach. In uremic condition, it was revealed that both physiological and pathological crosslinks increase, the orientation of collagen fibers is disturbed, and the mineral crystal remains immature. These changes in material property cause deteriorated bone elasticity in theory, and in fact these changes are closely correlated with mechanical properties of bone elasticity in experimental CKD animals. However, it is difficult to obtain any information about these material changes from biopsied bone histological findings.³⁸