title: Association between serum pregnancy-associated plasma protein-A and bicarbonate in hemodialysis patients.
abstract: BACKGROUND
  Acidosis is associated with protein-energy malnutrition, inflammation, and bone disease, and low bicarbonate levels have been implicated in higher mortality rates in chronic kidney disease. Recently, the concentration of serum pregnancy-associated plasma protein-A (PAPP-A) has become accepted as a prognostic marker in hemodialysis patients. This study determined the relationship between PAPP-A and bicarbonate levels in these patients.
  
  
  METHODS
  The study enrolled 65 hemodialysis patients (41 males, 24 females) and 26 control subjects (11 males, 15 females). Serum PAPP-A, intact parathormone (iPTH), calcium, phosphorus (P), and bicarbonate levels were measured. Correlations between PAPP-A and bicarbonate, iPTH, calcium, and phosphorus were evaluated.
  
  
  RESULTS
  Median PAPP-A levels were significantly higher in hemodialysis patients [15.1 (<0.03-158.8) ng/ml] than in control subjects [6.6 (<0.03-16.4) ng/ml] (P < 0.05). There were statistically significant correlations between serum PAPP-A and bicarbonate, iPTH, and P in hemodialysis patients but not in control subjects.
  
  
  CONCLUSIONS
  Elevation of serum PAPP-A has been found in hemodialysis patients and its significant correlation with bicarbonate suggests that it may be a prognostic factor.
authors.affiliation: Dr Lutfi Kirdar Training Hospital, Istanbul, Turkey.
authors.forename: Zerrin
authors.initials: Z
authors.lastname: Bicik
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Coskun
authors.forename: Mustafa
authors.initials: M
authors.lastname: Serteser
authors.forename: Atilla
authors.initials: A
authors.lastname: Bulur
authors.forename: Meral
authors.initials: M
authors.lastname: Mese
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Unsal
mesh_terms: D000328:Adult; D001639:Bicarbonates / Q000097:blood*; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011247:Pregnancy; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D006435:Renal Dialysis
chemical_list: D001639:Bicarbonates; D010281:Parathyroid Hormone; D010758:Phosphorus; D011266:Pregnancy-Associated Plasma Protein-A; D002118:Calcium
keywords: PAPP-A; acidosis; acute coronary syndrome; bicarbonate; hemodialysis