Correlation between histomorphometric parameters of bone resorption and serum type 5b tartrate-resistant acid phosphatase in uremic patients on maintenance hemodialysis.
BACKGROUND
Serum tartrate-resistant acid phosphatase 5b (TRACP) is a new marker of potential clinical use to monitor osteoclastic activity and bone resorption rate. The relationship between histomorphometric parameters of bone resorption and serum TRACP was evaluated in 14 chronically dialyzed patients and 6 healthy control subjects.


METHODS
All patients underwent bone biopsies and serum biochemical testing for TRACP, intact parathyroid hormone (iPTH), pyridinoline cross-linked telopeptide domain of type I collagen (ICTP), total calcium, phosphorus, and albumin, which were measured at the time of biopsy.


RESULTS
Bone histological examination showed predominant hyperparathyroid bone disease (HPT) in 6 patients, mixed uremic osteodystrophy in 3 patients, low-turnover osteomalacia in 1 patient, and adynamic bone disease in 4 patients. Mean TRACP activity was 3.25 +/- 0.59 U/L in control subjects. Median TRACP activity was significantly greater in patients with HPT (11.97 +/- 8.92 U/L) than those with other types of renal osteodystrophy (ROD; 2.17 +/- 0.61 U/L). Serum iPTH levels were greatest in all patients with HPT, but also were significantly elevated in 7 of 8 patients with other types of ROD. Serum ICTP levels also were significantly elevated in all patients with HPT and 6 of 8 patients with other types of ROD. Serum TRACP levels correlated more strongly with histological parameters of osteoclasts than those of erosion. Also, correlations between TRACP and histological parameters of osteoclasts were stronger than those of iPTH and ICTP levels.


CONCLUSIONS
These early results suggest that serum TRACP levels correlate well with histological indices of osteoclasts and may serve as a specific marker for osteoclastic activity in patients with renal bone disease.
Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. pchu@seed.net.tw
Pauling
P
Chu
Tsu-Yi
TY
Chao
Yuh-Feng
YF
Lin
Anthony J
AJ
Janckila
Lung T
LT
Yam
D000135:Acid Phosphatase / Q000097:blood*; D001862:Bone Resorption / Q000473:pathology*; D001842:Bone and Bones / Q000473:pathology*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D010018:Osteomalacia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006435:Renal Dialysis; D000071681:Tartrate-Resistant Acid Phosphatase; D014511:Uremia / Q000097:blood* / Q000473:pathology / Q000628:therapy
D007527:Isoenzymes; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase