title: Sclerostin declines during hemodialysis and appears in Dialysate.
abstract: OBJECTIVE
  Sclerostin, a soluble inhibitor of Wnt-signaling, inhibits bone formation. We assessed the impact of dialysis on serum sclerostin and whether sclerostin is detectable in effluent dialysates.
  
  
  METHODS
  In a prospective study of 54 prevalent hemodialysis patients, parameters of bone and mineral metabolism were assessed at the beginning and at the end of dialysis. In a subset of patients (n = 19) sclerostin was measured in serum at start, 1, 2, and 3 h of dialysis and in the effluent dialysate at several points in time.
  
  
  RESULTS
  Sclerostin serum levels decreased from median 71.4 pmol/l to 43.5 pmol/l during dialysis (p < 0.0001). In patients with high pre-dialysis sclerostin serum levels, sclerostin was detected in the dialysate. Higher Kt/V correlated with greater relative decrease of sclerostin (r = 0.467; p = 0.001).
  
  
  CONCLUSIONS
  Sclerostin is dialysable. Furthermore, sclerostin serum levels decrease during dialysis. Whether targeting lower sclerostin levels by means of improved dialysis adequacy has direct relevance to bone disease remains to be shown.
authors.affiliation: Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Bernhard O
authors.initials: BO
authors.lastname: Bielesz
authors.forename: Till
authors.initials: T
authors.lastname: Hempfing
authors.forename: Heidi
authors.initials: H
authors.lastname: Kieweg
authors.forename: Rodrig
authors.initials: R
authors.lastname: Marculescu
authors.forename: Martin
authors.initials: M
authors.lastname: Haas
authors.forename: Daniel
authors.initials: D
authors.lastname: Cejka
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000368:Aged; D019485:Bone Morphogenetic Proteins / Q000097:blood*; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D005819:Genetic Markers; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012737:Sex Factors
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D019485:Bone Morphogenetic Proteins; D015314:Dialysis Solutions; D005819:Genetic Markers; C422903:SOST protein, human