Bone GLA protein in predialysis chronic renal failure. Effects of 1,25(OH)2D3 administration in a long-term follow-up

Coen, G; Mazzaferro, Sandro; Bonucci, E.; Taggi, Franco; Ballanti, P.; Bianchi, Anna R.; Donato, Giuseppe; Massimetti, Carlo; Smacchi, Antonella; Cinotti, Giulio A.

doi:10.1038/ki.1985.198

Cited by 41 publications

(24 citation statements)

References 16 publications

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“…Others have found a correlation between serum osteocalcin and serum creatinine in adults with predialysis renal failure or in those undergoing hemodialysis (8,(17)(18)(19). As in our study of children on CAPD, Epstein et al (17) found no correlation between serum osteocalcin and creatinine in adults on CAPD.…”

Section: Discussioncontrasting

confidence: 47%

“…When renal function declines to less than 20 ml/min per 1.73 m2, serum concentrations increase and can be 20-50 times higher than normal. The interpretation of osteocalcin levels in those patients with renal osteodystrophy, therefore, is a product of at least two independent determining factors-decreased renal function and increased bone turnover (16)(17)(18). In the present study, we have measured the clearance of osteocalcin in 16 infants and children on CAPD.…”

Section: Discussionmentioning

confidence: 99%

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Clearance of Osteocalcin by Peritoneal Dialysis in Children with End-Stage Renal Disease

et al. 1987

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ABSTRACT. Osteocalcin is a bone-specific protein whose concentration in blood is a direct reflection of bone turnover. In chronic renal failure, circulating osteocalcin is elevated. This elevation is due to decreased renal clearance and, in some patients, increased bone turnover secondary to renal osteodystrophy. In children receiving continuous ambulatory pe;iton~al-dialysis, mean serum-osteocalcin concentrations are substantiallv lower than in similar Datients on hemodyalysis (1). his difference may be due to clearance of the protein by the peritoneal membrane. To test this possibility we examined osteocalcin in 16 infants and adolescents undergoing continuous ambulatory peritoneal dialysis with two commercially available glucosebased dialysis solutions (2.5 and 4.25% Dianeal). Mass transfer of osteocalcin over 5-h dialysis exchange periods was -18.9 + 2.8 and -28.4 + 7.8 pg for the low and high glucose solutions, respectively. Serum levels fell over the course of single exchange periods in concert with increasing dialysate concentrations. There were significant correlations between initial blood concentrations of osteocalcin and the total amount of osteocalcin transferred ( r = 0.609 and 0.642 for the high and low glucose solutions, respectively, p < 0.05). There were also strong correlations between the mass transfers of osteocalcin and those of creatinine ( p < 0.05) and total protein ( p < 0.01) with the 4.25% glucose exchange. The relationships were weaker with the 2.5% glucose exchange. Fractionation of serum revealed a single immunoreactive peak eluting coincident with intact osteocalcin, but two or three immunoreactive peaks were identified in matching dialysate samples, suggesting that both intact osteocalcin and circulating fragments are transferred by the peritoneal membrane. The efficient clearance of the protein or its metabolic fragments may be a significant factor in the natural history of renal osteodystrophy seen in these patients. (Pediatr Res 21: 296-300,1987) Abbreviations Gla, y-carboxyglutamic acid CAPD, continuous ambulatory peritoneal dialysis

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Clearance of Osteocalcin by Peritoneal Dialysis in Children with End-Stage Renal Disease

et al. 1987

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“…High PTH levels have been associated with increased serum levels of osteocalcin [27]; this is probably due to increased bone remodeling. Previous data by others [13] have shown that long-term administra tion of calcitriol to uremic patients decreases serum osteocalcin levels. This change may be the result of a decrease in PTH levels, in order to separate the direct stimulatory effect of calcitriol on osteocalcin production from an opposite effect mediated through a decrease in PTH levels.…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, it has been reported that in uremic patients, calcitriol adminis tration leads to a decrease in serum parathyroid hormone (PTH) [13]. In dialysis patients serum osteocalcin levels are elevated as a result both of a decrease in renal clear ance and an increase in its production due to the high bone turnover [12].…”

Section: Introductionmentioning

confidence: 91%

“…Since osteocalcin is excreted by the kidney [10,11] serum levels are increased in patients with renal failure. In uremic and hemodialysis (HD) patients a direct relationship between serum osteocalcin concentra tion and histological parameters of bone formation has been observed [12][13][14]. Experiments in vivo and in vitro have demonstrated that calcitriol increases osteocalcin production [15][16].…”

Section: Introductionmentioning

confidence: 98%

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Osteocalcin Levels in Uremic Patients: Influence of Calcitriol Treatment through Two Different Routes and Type of Dialysis

Martı́nez

Selgas²,

Miguel³

et al. 1991

Nephron

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Osteocalcin, the most abundant non-collagen protein of bone, is synthesized by the osteoblast. Serum osteocalcin concentration depends primarily on new cellular synthesis, and is a sensitive marker of bone turnover reflecting osteoblastic function. In uremic and hemodialysis (HD) patients, a direct relationship between serum osteocalcin and histological parameters of bone formation has been observed. The modality of dialysis may influence serum osteocalcin levels though the available data are controversial. The aim of this study is to assess the acute and chronic effects of calcitriol and the influence of modality of dialysis on serum osteocalcin levels. Twelve patients on continuous ambulatory peritoneal dialysis (CAPD) were treated with calcitriol. For control purposes, 24 patients, 12 on CAPD and 12 on HD, not treated with calcitriol serum osteocalcin levels were included. In CAPD patients previously treated with calcitriol, serum osteocalcin levels were higher than in nontreated patients. The higher levels occur independent of serum levels of parathyroid hormone (PTH), Ca and P. Hemodialysis patients had osteocalcin levels similar to those of CAPD patients under calcitriol treatment. However, the levels of HD patients were higher than CAPD nontreated patients. Serum ionized Ca was similar in CAPD and HD nontreated patients; however, total Ca was significantly higher in HD than in CAPD patients, both with and without calcitriol. After the intravenous administration of calcitriol, serum osteocalcin levels increased from 9.2 + 2.5 to 13.5 + 5.4 ng/ml (p < 0.01). These changes were accompanied by a decrease in intact-PTH levels from 88 + 74 to 66 + 51 pg/ml and by an increase in serum ionized Ca²⁺ from 1.27 + 0.09 to 1.31 + 0.1 mmol/l. In conclusion, our study shows osteocalcin levels above the normal range in all dialysis patients. They were influenced by calcitriol treatment and modality of dialysis. Acute intravenous calcitriol administration induced an increase in osteocalcin despite the concomitant decrease in PTH plasma levels.

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Serum bone gla-protein in multiple myeloma

Bataille

Delmas

Sany

1987

Cancer

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Serum bone gla-protein (SBGP), a marker of bone formation, was measured by radioimmunoassay in 57 patients with multiple myeloma (MM) and correlated with presenting features and disease activity. As a whole, patients with MM did not differ from normal controls or from patients with a monoclonal gammopathy of undetermined significance, but a significant percentage of abnormal values of SBGP was found in this MM population (18% of cases, P less than 0.005). At the time of diagnosis, SBGP was significantly lower in advanced disease (Stage III) than in less active disease (Stage I and II) with mean values of 4.4 +/- 2.7 ng/ml and 7.1 +/- 1.9 ng/ml, respectively (P less than 0.02). SBGP levels inversely correlated with the severity of the disease, the lowest values being observed in patients with extensive lytic bone lesions frequently associated with hypercalcemia (2.9 +/- 1.7 ng/ml). These data suggest the presence of a strong osteoblastic inhibition, at the body level, in the majority of patients (80%) with active osteoclastic MM (uncoupled process). However, a small subset of myeloma patients (20%) presented coupled MM, as defined by increased bone resorption (i.e., lytic bone lesions +/- hypercalcemia) and increased bone formation (i.e., increased SBGP values). Similar features of coupling-uncoupling were observed during disease progression. Finally, serial studies performed in 15 patients confirm these findings and the relation of SBGP levels to disease activity. Of major interest was the observation of a return of SBGP levels from low to normal values during remission induction, after successful completion of a plateau phase. According to these data, SBGP appears to be a new and promising marker for the clinical evaluation of MM.

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Bone GLA protein in predialysis chronic renal failure. Effects of 1,25(OH)2D3 administration in a long-term follow-up

Cited by 41 publications

References 16 publications

Clearance of Osteocalcin by Peritoneal Dialysis in Children with End-Stage Renal Disease

Clearance of Osteocalcin by Peritoneal Dialysis in Children with End-Stage Renal Disease

Osteocalcin Levels in Uremic Patients: Influence of Calcitriol Treatment through Two Different Routes and Type of Dialysis

Serum bone gla-protein in multiple myeloma

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