Evaluation of Bone Biomarkers in Renal Osteodystrophy
Renal osteodystrophy (ROD) represents histological bone changes in patients with chronic kidney disease and is classified according to turnover and mineralization. This cross-sectional study evaluates several bone biomarkers and their ability to discriminate turnover and mineralization defects in he...
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MDPI AG
2024-11-01
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| author | Alinie Pichone Carlos Perez Gomes Carolina Aguiar Moreira Maria Lucia Fleiuss Farias Maurilo Leite |
| author_facet | Alinie Pichone Carlos Perez Gomes Carolina Aguiar Moreira Maria Lucia Fleiuss Farias Maurilo Leite |
| author_sort | Alinie Pichone |
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| description | Renal osteodystrophy (ROD) represents histological bone changes in patients with chronic kidney disease and is classified according to turnover and mineralization. This cross-sectional study evaluates several bone biomarkers and their ability to discriminate turnover and mineralization defects in hemodialysis (HD) patients. Bone-specific [BSAP] and total [tAP] alkaline phosphatase, procollagen-1 N-terminal propeptide [P1NP], C-terminal cross-linking telopeptide [CTX], intact [iPTH] and whole [wPTH] parathyroid hormone, sclerostin [SOST], fibroblast growth factor 23 [FGF-23], vitamin D, osteoprotegerin [OPG], and receptor activator of nuclear factor κB ligand [RANKL] were collected before the bone biopsy. Thirty-two patients were evaluated by bone histomorphometry, which identified mineralization defects and low and high turnover in 47%, 50%, and 41% of patients, respectively. Bone biomarkers (tAP, BSAP, CTX, P1NP) and hormones (iPTH, wPTH, and SOST) were capable of identifying low and high turnover (AUC > 0.877 and >0.857, respectively, <i>p</i> < 0.001). PTH plus AP had the best accuracy for identifying high turnover. BSAP > 2x, iPTH > 8x, and wPTH > 6x upper limit of normal range identified high turnover. Lower calcium values (Ca < 8.7 mg/dL) were correlated with mineralization defects. On the other hand, FGF-23, OPG, and RANKL did not impact the turnover and mineralization. While bone histomorphometry is not widely available, bone biomarkers such as BSAP, P1NP, PTH, and calcium allow the assessment of turnover and mineralization defects in HD patients. Then, using bone biomarkers may help clinicians define treatments for ROD and osteoporosis and monitor therapeutic response. |
| format | Article |
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| issn | 2075-1729 |
| language | English |
| publishDate | 2024-11-01 |
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| series | Life |
| spelling | doaj-art-6de339a447474fc7b22a13f39617c6392025-08-20T02:00:24ZengMDPI AGLife2075-17292024-11-011412154010.3390/life14121540Evaluation of Bone Biomarkers in Renal OsteodystrophyAlinie Pichone0Carlos Perez Gomes1Carolina Aguiar Moreira2Maria Lucia Fleiuss Farias3Maurilo Leite4Division of Nephrology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universitária, Rio de Janeiro 21941-617, RJ, BrazilDivision of Nephrology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universitária, Rio de Janeiro 21941-617, RJ, BrazilDivision of Endocrinology, Academic Research Center of Pro Renal Institute, Rua Vicente Machado, 2190, Curitiba 80060-900, PR, BrazilDivision of Endocrinology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universitária, Rio de Janeiro 21941-617, RJ, BrazilDivision of Nephrology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universitária, Rio de Janeiro 21941-617, RJ, BrazilRenal osteodystrophy (ROD) represents histological bone changes in patients with chronic kidney disease and is classified according to turnover and mineralization. This cross-sectional study evaluates several bone biomarkers and their ability to discriminate turnover and mineralization defects in hemodialysis (HD) patients. Bone-specific [BSAP] and total [tAP] alkaline phosphatase, procollagen-1 N-terminal propeptide [P1NP], C-terminal cross-linking telopeptide [CTX], intact [iPTH] and whole [wPTH] parathyroid hormone, sclerostin [SOST], fibroblast growth factor 23 [FGF-23], vitamin D, osteoprotegerin [OPG], and receptor activator of nuclear factor κB ligand [RANKL] were collected before the bone biopsy. Thirty-two patients were evaluated by bone histomorphometry, which identified mineralization defects and low and high turnover in 47%, 50%, and 41% of patients, respectively. Bone biomarkers (tAP, BSAP, CTX, P1NP) and hormones (iPTH, wPTH, and SOST) were capable of identifying low and high turnover (AUC > 0.877 and >0.857, respectively, <i>p</i> < 0.001). PTH plus AP had the best accuracy for identifying high turnover. BSAP > 2x, iPTH > 8x, and wPTH > 6x upper limit of normal range identified high turnover. Lower calcium values (Ca < 8.7 mg/dL) were correlated with mineralization defects. On the other hand, FGF-23, OPG, and RANKL did not impact the turnover and mineralization. While bone histomorphometry is not widely available, bone biomarkers such as BSAP, P1NP, PTH, and calcium allow the assessment of turnover and mineralization defects in HD patients. Then, using bone biomarkers may help clinicians define treatments for ROD and osteoporosis and monitor therapeutic response.https://www.mdpi.com/2075-1729/14/12/1540bone biomarkersbone biopsyhemodialysishistomorphometrymineralizationrenal osteodystrophy |
| spellingShingle | Alinie Pichone Carlos Perez Gomes Carolina Aguiar Moreira Maria Lucia Fleiuss Farias Maurilo Leite Evaluation of Bone Biomarkers in Renal Osteodystrophy Life bone biomarkers bone biopsy hemodialysis histomorphometry mineralization renal osteodystrophy |
| title | Evaluation of Bone Biomarkers in Renal Osteodystrophy |
| title_full | Evaluation of Bone Biomarkers in Renal Osteodystrophy |
| title_fullStr | Evaluation of Bone Biomarkers in Renal Osteodystrophy |
| title_full_unstemmed | Evaluation of Bone Biomarkers in Renal Osteodystrophy |
| title_short | Evaluation of Bone Biomarkers in Renal Osteodystrophy |
| title_sort | evaluation of bone biomarkers in renal osteodystrophy |
| topic | bone biomarkers bone biopsy hemodialysis histomorphometry mineralization renal osteodystrophy |
| url | https://www.mdpi.com/2075-1729/14/12/1540 |
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