Effect of chronic renal failure on bone turnover and bone alkaline phosphatase isoforms

Magnusson, Per; Sharp, Christopher; Magnusson, Martin; Risteli, Juha; Davie, M. W. J.; Larsson, Laşse

doi:10.1046/j.1523-1755.2001.00794.x

Cited by 101 publications

(118 citation statements)

References 43 publications

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“…We used instead biochemical markers of bone turnover, but it is unclear to what extent these abnormalities correlate with bone histologic patterns in kidney transplant recipients with or without CKD. Serum CTX is accepted as a marker of bone resorption in patients with normal kidney function (27), but it is unknown to what extent it is diagnostic of histologically defined high turnover bone disease in kidney transplant recipients with or without CKD, especially because levels of CTX are also influenced by kidney function (48). However, we have found similar results when examining other serum markers of bone turnover, such as serum OC levels, an accepted marker of bone formation (28).…”

Section: Discussionsupporting

confidence: 61%

Associations between Serum Leptin Level and Bone Turnover in Kidney Transplant Recipients

Kövesdy

Molnar

Czira

et al. 2010

Clinical Journal of the American Society of Nephrology

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Results: Higher leptin levels were associated with higher PTH and lower vitamin D levels, and adjustment for vitamin D attenuated the association between leptin and PTH. However, higher leptin was also significantly associated with lower levels of the bone turnover markers: 1 SD higher leptin was associated with 0.13 lower log-OC (؊0.17, ؊0.08, P < 0.001) and 0.030 lower log-CTX (؊0.045, ؊0.016, P < 0.001) after multivariable adjustments. Path analysis indicated that the association of leptin with PTH was mostly mediated through vitamin D, and that the association between leptin and bone turnover was independent of PTH and vitamin D.Conclusions: Elevated leptin level is associated with lower bone turnover independent of its effects on serum PTH in kidney transplant recipients.

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Section: Discussionsupporting

confidence: 61%

Associations between Serum Leptin Level and Bone Turnover in Kidney Transplant Recipients

Kövesdy

Molnar

Czira

et al. 2010

Clinical Journal of the American Society of Nephrology

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confidence: 99%

“…6 Unlike serum PTH that originates from the parathyroid glands and affects bone metabolism, 3,4,7 serum AlkPhos stems from the bone itself and reflects internal bone activities. 6 Incrementally higher levels of serum AlkPhos can be seen with worsening magnitude of bone turnover. 8,9 We recently showed that surrogates of CKD-MBD, including higher serum levels of minerals and higher AlkPhos levels, were associated with increased all-cause death risk in a 2-yr cohort of 58,000 MHD patients.…”

mentioning

confidence: 99%

Serum Alkaline Phosphatase Predicts Mortality among Maintenance Hemodialysis Patients

Regidor

Kövesdy

Mehrotra³

et al. 2008

Journal of the American Society of Nephrology

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Several observational studies have demonstrated that serum levels of minerals and parathyroid hormone (PTH) have U-or J-shaped associations with mortality in maintenance hemodialysis patients, but the relationship between serum alkaline phosphatase (AlkPhos) and risk for all-cause or cardiovascular death is unknown. In this study, a 3-yr cohort of 73,960 hemodialysis patients in DaVita outpatient dialysis were studied, and the hazard ratios for all-cause and cardiovascular death were higher across 20-U/L increments of AlkPhos, including within the various strata of intact PTH and serum aspartate aminotransferase. In the fully adjusted model, which accounted for demographics, comorbidity, surrogates of malnutrition and inflammation, minerals, PTH, and aspartate aminotransferase, AlkPhos Ն120 U/L was associated with a hazard ratio for death of 1.25 (95% confidence interval 1.21 to 1.29; P Ͻ 0.001). This association remained among diverse subgroups of hemodialysis patients, including those positive for hepatitis C antibody. A rise in AlkPhos by 10 U/L during the first 6 mo was incrementally associated with increased risk for death during the subsequent 2.5 yr. In summary, high levels of serum AlkPhos, especially Ͼ120 U/L, are associated with mortality among hemodialysis patients. Prospective controlled trials will be necessary to test whether serum AlkPhos measurements could be used to improve the management of renal osteodystrophy. 19: 219319: -220319: , 200819: . doi: 10.1681 In advanced chronic kidney disease (CKD; stages 3 through 5), secondary hyperparathyroidism (SHPT), along with renal osteodystrophy, is common and may be associated with abnormal mineral metabolism and/or abnormal serum or tissue mineral levels, vascular calcifications, and poor survival, espe- contributed to the study design and manuscript preparation and reviewed and approved the final manuscript. J Am Soc Nephrol

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“…The relationship between higher ALP and fracture could be explained due to high bone turnover [17] and it is recommended to routine measure serum ALP in the treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD) [1]. ALP is primary secreted by the liver and bone, and small amounts are secreted by kidneys, intestine and leukocytes [18].…”

Section: Resultsmentioning

confidence: 99%

The frequency of bone fractures among patients with chronic kidney disease not on dialysis: two-year follow-up

Figurek

Vlatković

Vojvodic

et al. 2017

Romanian Journal of Internal Medicine

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Introduction. Renal osteodystrophy is a severe complication of chronic kidney disease (CKD) that increases morbidity and mortality in these patients. Mineral and bone disorder starts early in CKD and affects the incidence of bone fractures. The aim of this study was to observe the frequency of diverse bone fractures in patients with CKD not on dialysis.Methods. This cohort study included 68 patients that were followed during the two-year period. The patients were divided into two cohorts: one that developed bone fractures and the other that did not. There were 35 (51.5%) men and 33 (48.5%) women. The mean age of patients ranged 62.88±11.60 years. During follow-up serum values of chronic kidney disease -mineral and bone indicators were measured. The methods of descriptive and analytical statistics were used in order to analyze obtained data.Results. During this two-year follow-up seven patients developed bone fractures. Among them, females dominated (6 patients) compared to males (only 1 patient). The most common were fractures of forearm. The mean level of parathyroid hormone (PTH) at the beginning of the monitoring was higher in the group of patients with bone fractures (165.25 ± 47.69 pg/mL) in regard to another group (103.96 ± 81.55 pg/mL). After two-year follow-up, this difference became statistically significant at the level p < 0.05. Patients that developed bone fractures had higher FRAX (Fracture Risk Assessment) score compared to another group.Conclusion. In our study, about 10% of patients had bone fractures in the two-year follow-up period. Patients who developed fractures had a higher PTH level and FRAX score.

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Effect of chronic renal failure on bone turnover and bone alkaline phosphatase isoforms

Abstract: There are selective differences between the BALP isoforms in CRF compared with healthy adults. The commercial BALP immunoassays are comparable with each other but are unable to distinguish the BALP isoform-specific differences in CRF patients.

Cited by 101 publications

References 43 publications

Associations between Serum Leptin Level and Bone Turnover in Kidney Transplant Recipients

Associations between Serum Leptin Level and Bone Turnover in Kidney Transplant Recipients

Serum Alkaline Phosphatase Predicts Mortality among Maintenance Hemodialysis Patients

The frequency of bone fractures among patients with chronic kidney disease not on dialysis: two-year follow-up

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