Effect of hemodialysis and renal failure on serum biochemical markers of bone turnover.
The aim of the present study was to evaluate the effect of hemodialysis and renal failure on serum bone markers. Serum total alkaline phosphatase (TAP), procollagen type I aminoterminal propeptide (PINP), and beta-carboxyterminal telopeptide of type I collagen (beta-CTX), as well as intact parathyroid hormone (iPTH), creatinine, and total protein were measured in 14 patients with endstage renal disease (ESRD) before and at 1, 2, and 4 h during a hemodialysis session, and at the same sampling interval in 6 renal transplant recipients. The results were compared to those obtained in 20 healthy adults. All patients showed increased baseline mean values of PINP, beta-CTX, and iPTH. Beta-CTX differed significantly between hemodialysis patients and renal transplant recipients. TAP and beta-CTX were the only markers which correlated with iPTH ( P << 0.05) and creatinine values ( P << 0.001), respectively. Renal transplant recipients did not show significant variations in the evolution of mean values of bone markers throughout the study, whereas, during the dialysis period, all the bone markers analyzed in the study showed a significant change. The change differed depending on the marker considered: beta-CTX showed a significant decrease at the end of the session, TAP increased at this time and, although PINP showed an initial increase during hemodialysis, no significant changes were observed at the end of the session. We conclude that bone markers are significantly influenced by hemodialysis, especially serum TAP and beta-CTX. ESRD is associated with an increase in these bone markers, in some cases related to iPTH values and in others to glomerular function. These findings should be taken into account when evaluating bone markers in these patients.
Alvarez
Luisa
L
Service of Clinical Biochemistry, Hospital Clìnic, C/Villarroel 170, 08036 Barcelona, Spain. lalvarez@medicina.ub.es
Torregrosa
Jose-Vicente
JV
Peris
Pilar
P
Monegal
Ana
A
Bedini
Jose-Luis
JL
Martinez De Osaba
Maria-Jesús
MJ
Filella
Xavier
X
Martin
Gloria
G
Ricos
Carmen
C
Oppenheimer
Federico
F
Ballesta
Antonio-Manuel
AM
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016723:Bone Remodeling / Q000502:physiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000473:pathology*
D015415:Biomarkers