Monitoring of bone resorption after renal transplantation by measuring the urinary excretion of pyridinium cross-links.
The urinary excretion of pyridinium cross-links was measured in 70 second morning urine samples from 49 patients following renal transplantation. One and three months after renal transplantation, the urinary excretion of pyridinium cross-links was higher (p < 0.05) than at one week after transplantation. At all times after transplantation, the values for the excretion of pyridinium cross-links were correlated with the bone alkaline phosphatase concentrations (p < 0.001). However, there was no correlation between parathyrin concentrations and the values for the excretion of pyridinium cross-links (p > 0.05). This rise in the excretion of pyridinium cross-links is probably due to an increase of bone resorption caused by cyclosporin A and/or glucocorticoids. In the case of 17 urines with excretion values of pyridinium cross-links above the upper reference limit (pyridinoline equivalents, 93 mumol/mol creatinine), only 2 (12%) of the corresponding sera showed increased bone alkaline phosphatase values. In patients following renal transplantation simultaneous assessment of bone formation and bone resorption (determined from bone alkaline phosphatase serum concentrations and the excretion of pyridinium cross-links) may therefore enhance the diagnostic sensitivity for detecting effects on bone metabolism.
Withold
W
W
Institut für Klinische Chemie und Laboratoriumsdiagnostik, Heinrich-Heine-Universität Düsseldorf, Germany.
Degenhardt
S
S
Heins
M
M
Grabensee
B
B
Reinauer
H
H
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001862:Bone Resorption / Q000097:blood / Q000209:etiology / Q000652:urine*; D001842:Bone and Bones / Q000201:enzymology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010281:Parathyroid Hormone / Q000097:blood; D011726:Pyridinium Compounds / Q000652:urine*
D010281:Parathyroid Hormone; D011726:Pyridinium Compounds; D000469:Alkaline Phosphatase