Effects of 1,25(OH)2D3 Administration on Serum Bone GLA Protein in Predialysis Chronic Renal Failure

Coen, G; Mazzaferro, Sandro; Donato, Giuseppe; Massimetti, Carlo; Ballanti, P.; Bondatti, Franco; Rocca, Carlo Della; Smacchi, Antonella; Mantazzoli, Flavia; Cinotti, Giulio A.

doi:10.1007/978-1-4684-5206-8_38

Cited by 5 publications

(4 citation statements)

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“…our findings are in agreement with a transient, calcitriol-mediated stimulation of osteoblastic synthesis of these bone markers [20][21][22]. The phase of increment in serum levels of the bone markers is followed by a reduc tion [23] together with a fall of Pcoll-l-C, in line with a decrease in size and activity of the osteoblastic population and with the expected improvement of the osteodystrophic lesion.…”

Section: Discussionsupporting

confidence: 78%

ProcoUagen Type 1 C-Terminal Extension Peptide Serum Levels following Parathyroidectomy in Hyperparathyroid Patients

Coen¹,

Mazzaferro²,

Antoni³

et al. 1994

Am J Nephrol

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ProcoUagen type 1 is mainly synthesized by osteoblasts and, after cleavage of the N- and C-terminal extension peptides, is utilized for collagen fibril deposition in the osteoid tissue. Serum levels of C-terminal extension peptide (Pcoll-1-C) of the procoUagen molecule has been considered a useful marker for the evaluation of the rate of osteoblastic procoUagen synthesis. To appraise whether in vivo parathyroid hormone (PTH) plays a suppressive role in the synthesis of procoUagen type 1, a study has been carried out in 16 patients, 10 with severe secondary hyperparathyroidism of chronic renal failure and 6 with primary hyperparathyroidism. Following parathyroidectomy (PTX), in chronic renal failure patients a 94% fall in serum intact iPTH and a decline of serum calcium to hypocalcemic levels requiring calcitriol administration were observed. Serum Pcoll-1-C increased markedly with a peak after 7 days and a subsequent decline. Similar changes were observed for alkaline phosphatase and osteocalcin. In primary hyperparathyroidism, PTX was followed by an 88% drop in iPTH and mild hypocalcemia not requiring calcitriol administration. Also in this group serum Pcoll-1-C increased significantly with the same time course, unaccompanied by changes in alkaline phosphatase and osteocalcin. In 4 unsuccessfully neck-operated control patients no change in serum Pcoll-1-C levels was recorded during a period of 2 weeks postoperatively. In conclusion, acute withholding of parathyroid hypersecretion is accompanied by an abrupt and transitory increase of serum Pcoll-1-C, not dependent on calcitriol administration. Hypocalcemia following PTX may in part be due to uncoupling of bone formation and resorption.

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Section: Discussionsupporting

confidence: 78%

ProcoUagen Type 1 C-Terminal Extension Peptide Serum Levels following Parathyroidectomy in Hyperparathyroid Patients

Coen¹,

Mazzaferro²,

Antoni³

et al. 1994

Am J Nephrol

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“…Hyperparathyroidism induced by former renal failure may persist for many years after the graft [5,21], and even indefinitely in most cases [4], Linked to the slow rate of involution of hyperplastic parathyroids [22], it probably depends on the degree of hyperplasia at grafting time [6] or autonomous hyperparathyroidism [8][9][10].…”

Section: Excessive Parathyroid Secretionmentioning

confidence: 99%

Acute Oral Calcium Load Decreases Parathyroid Secretion and Suppresses Tubular Phosphate Loss in Long-Term Renal Transplant Recipients

Dumoulin¹,

Hory

Nguyen³

et al. 1995

Am J Nephrol

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Persistent hyperparathyroidism and impaired tubular reabsorption of phosphate (P) are common after kidney transplantation. In order to assess the suppressibility of these abnormalities, we studied the effects of a single oral calcium (Ca) load (1 g) in 7 healthy subjects (HS) and in 14 normocalcemic long-term renal transplant recipients with good renal function (RT). In HS and RT, serum and urinary Ca were similar at baseline, and increased (p < 0.001) to the same extent after Ca ingestion. Serum parathyroid hormone (PTH) and nephrogenic cAMP (NcAMP) levels were higher at baseline in RT than HS (mean ± SEM; respectively, PTH 7.8 ± 0.8 vs. 3.5 ± 0.6 pmol/l, p < 0.001, and NcAMP 24.8 ± 2.3 vs. 13.9 ± 2.3 nmol/lGFRp < 0.01). After Ca, PTH (p < 0.001) and NcAMP (p < 0.01) decreased markedly in both RT and HS. Maximal changes in PTH and NcAMP were larger in RT than HS (PTH -3.3 ± 0.4 vs. -2.1 ± 0.03 pmol/l, p < 0.01, and NcAMP -18.2 ± 3.3 vs. -8.1 ± 2.6 nmol/l GFR, p < 0.05). Although PTH levels remained significantly higher in RT than HS from baseline to the end of the study (p < 0.001), PTH decreased to the normal range in RT after Ca load. Moreover, NcAMP reached similar values in RT and HS after Ca (16.0 ± 3.2 vs. 13.2 ± 2.8 nmol/l GFR at the end of the survey, NS). At baseline, RT had higher phosphaturia than HS (246 ± 25 vs. 127 ± 19 µmol/l, p < 0.01), and Ca ingestion lowered phosphaturia to similar values in both RT and HS (116 ± 13 vs. 95 ± 7 µmol/l GFR, NS). Renal P threshold expressed as TmP/GFR and tubular reabsorption rate of P were lower in RT than HS at baseline, and resumed normal values after Ca. To summarize, in normocalcemic long-term kidney transplant recipients, a single oral Ca intake acutely blunted the excessive PTH secretion and increased tubular reabsorption of P up to a normal range. We conclude therefore, that PTH is a main factor of tubular P loss in these patients.

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“…For example, in predialysis patients the ad ministration of 1,25-dihydroxycholecalciferol induced, within 2 weeks, an increase in serum BGP levels while long-term treatment was associated with a fall in the humoral parameter, together with changes in histomorphometric parameters [25]. It follows that biochemical measurements can be expected to give useful predictions only after a prolonged period of treatment stability.…”

Section: Discussionmentioning

confidence: 99%

Osteocalcin, iPTH, Alkaline Phosphatase and Hand X-Ray Scores as Predictive Indices of Histomorphometric Parameters in Renal Osteodystrophy

Mazzaferro

Coen

Ballanti

et al. 1990

Nephron

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To evaluate the relationship between hyperparathyroid bone X-ray lesion, biochemical parameters and bone histology in chronic renal failure, 59 patients (52 ± 14.9 years; Crs 4.7 ± 2.2 mg/dl, mean ± SD) on conservative treatment and 103 (48 ± 14 years) on hemodialysis (from 48.4 ± 36.7 months) were studied. Right-hand X-ray was carried out for evaluation of the scores (0–3) of acroosteolysis (score A) and subperiosteal resorption (score B). Serum iPTH, osteocalcin and alkaline phosphatase (AP) were measured. In addition in a subset of 53 patients, 30 in predialysis and 23 in dialysis, a bone biopsy was performed for histomorphometry. In predialysis the scores A and B correlated with bone GLA protein (BGP) (p < 0.001), iPTH (p < 0.01), AP (p < 0.05) and osteoid surface (p < 0.05 and 0.01 respectively). In hemodialysis the same level of significant correlation (p < 0.001) was found between the scores and the three humoral parameters. Score A correlated with active osteoblastic surface and active resorption surface while score B correlated with active osteoblastic surface (p < 0.01), osteoid surface and active resorption surface (p < 0.05). Multiple regression analysis carried out to establish the predictive variables of bone histologic lesions (active resorption surface and active osteoblastic surface) singled out BGP in predialysis and AP and the two scores in dialysis. We conclude that serum BGP, as compared to PTH and AP, prevails as a valid marker of hyperparathyroid bone lesion in predialysis, while in dialysis it does not seem to add further information to that carried by other variables. On practical grounds bone histology cannot be satisfactorily predicted by noninvasive methods, especially in hemodialysis.

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Effects of 1,25(OH)2D3 Administration on Serum Bone GLA Protein in Predialysis Chronic Renal Failure

Cited by 5 publications

References 5 publications

ProcoUagen Type 1 C-Terminal Extension Peptide Serum Levels following Parathyroidectomy in Hyperparathyroid Patients

ProcoUagen Type 1 C-Terminal Extension Peptide Serum Levels following Parathyroidectomy in Hyperparathyroid Patients

Acute Oral Calcium Load Decreases Parathyroid Secretion and Suppresses Tubular Phosphate Loss in Long-Term Renal Transplant Recipients

Osteocalcin, iPTH, Alkaline Phosphatase and Hand X-Ray Scores as Predictive Indices of Histomorphometric Parameters in Renal Osteodystrophy

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