Bone turnover markers predict type of bone histomorphometry and bone mineral density in Asian chronic haemodialysis patients
| Autor: | Suwasin Udomkarnjananun, Pobe Luangjarmekorn, Somchai Eiam-Ong, Lalita Wattanachanya, Kearkiat Praditpornsilpa, Paweena Susantitaphong, Suthanit Laowalert, Pisut Katavetin, Tanatorn Khotavivattana |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Biopsy Osteoporosis 030232 urology & nephrology Urology 030204 cardiovascular system & hematology Risk Assessment Iliac crest Bone and Bones Bone remodeling 03 medical and health sciences 0302 clinical medicine Bone Density Renal Dialysis Internal medicine Preventive Health Services medicine Humans Vascular Calcification Chronic Kidney Disease-Mineral and Bone Disorder Bone mineral Receiver operating characteristic business.industry General Medicine Middle Aged Thailand medicine.disease medicine.anatomical_structure Parathyroid Hormone Kidney Failure Chronic Female Bone Remodeling Osteitis business Biomarkers Needs Assessment Kidney disease |
| Zdroj: | Nephrology. 25:163-171 |
| ISSN: | 1440-1797 1320-5358 |
| DOI: | 10.1111/nep.13593 |
| Popis: | BACKGROUND Although the levels of intact parathyroid hormone (iPTH) are well-controlled following the Kidney Disease Outcomes Quality Initiative guideline, the incidence of osteoporosis and fracture are still high in haemodialysis (HD) patients. This study was conducted to investigate the correlation between bone turnover markers, bone mineral density (BMD), and bone histomorphometry in HD patients. METHODS Twenty-two chronic HD patients were enrolled. Serum levels of bone turnover markers were measured. Double tetracycline-labelled iliac crest bone specimens were evaluated using specialized a computer program (Osteomeasure). The types of bone histomorphometry were classified based on turnover, mineralization and volume. BMD and coronary artery calcification were also determined. RESULTS Bone histomorphometry revealed osteitis fibrosa (50%), adynamic bone disease (45%) and mixed uremic osteodystrophy (5%). Serum iPTH level predicted high bone turnover with area under the receiver operating characteristic (ROC) of 0.833 (95% CI = 0.665-1.000, P = 0.008). Serum TRAP-5b also had ROC of 0.733 (95% CI = 0.517-0.950, P = 0.065). In addition, when using serum iPTH (cut-off 484.50 ng/mL) or serum TRAP-5b (cut-off 1.91 pg./mL) to predict high turnover, the sensitivity was 0.917. On the other hand, when both iPTH and TRAP-5B were above these cut-off, the specificity was 1.000. Low BMD and severe vascular calcification were commonly identified. However, there were no significant correlations between bone biomarkers and BMD or severe vascular calcification. CONCLUSION Although iPTH levels were close to the target of Kidney Disease Outcomes Quality Initiative guideline, abnormal bone histomorphometry, BMD, and severe vascular calcification are still common. Bone biopsy is still crucially required as an accurate diagnostic tool in providing optimal guide for the treatment. © 2019 Asian Pacific Society of Nephrology. |
| Databáze: | OpenAIRE |
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