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Journal of Bone and Mineral Metabolism

, Volume 22, Issue 3, pp 254–259 | Cite as

Effect of hemodialysis and renal failure on serum biochemical markers of bone turnover

  • Luisa Alvarez
  • Jose-Vicente Torregrosa
  • Pilar Peris
  • Ana Monegal
  • Jose-Luis Bedini
  • Maria-JesÚs Martinez De Osaba
  • Xavier Filella
  • Gloria Martin
  • Carmen Ricos
  • Federico Oppenheimer
  • Antonio-Manuel Ballesta
Article

Abstract

The aim of the present study was to evaluate the effect of hemodialysis and renal failure on serum bone markers. Serum total alkaline phosphatase (TAP), procollagen type I aminoterminal propeptide (PINP), and Β-carboxyterminal telopeptide of type I collagen (Β-CTX), as well as intact parathyroid hormone (iPTH), creatinine, and total protein were measured in 14 patients with endstage renal disease (ESRD) before and at 1, 2, and 4 h during a hemodialysis session, and at the same sampling interval in 6 renal transplant recipients. The results were compared to those obtained in 20 healthy adults. All patients showed increased baseline mean values of PINP, Β-CTX, and iPTH. Β-CTX differed significantly between hemodialysis patients and renal transplant recipients. TAP and Β-CTX were the only markers which correlated with iPTH (P ≪ 0.05) and creatinine values (P ≪ 0.001), respectively. Renal transplant recipients did not show significant variations in the evolution of mean values of bone markers throughout the study, whereas, during the dialysis period, all the bone markers analyzed in the study showed a significant change. The change differed depending on the marker considered: Β-CTX showed a significant decrease at the end of the session, TAP increased at this time and, although PINP showed an initial increase during hemodialysis, no significant changes were observed at the end of the session. We conclude that bone markers are significantly influenced by hemodialysis, especially serum TAP and Β-CTX. ESRD is associated with an increase in these bone markers, in some cases related to iPTH values and in others to glomerular function. These findings should be taken into account when evaluating bone markers in these patients.

Key words

Β-carboxyterminal telopeptide of type I collagen intact parathyroid hormone procollagen type I aminoterminal propeptide total alkaline phosphatase 

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Copyright information

© Springer-Verlag Tokyo 2004

Authors and Affiliations

  • Luisa Alvarez
    • 1
    • 2
  • Jose-Vicente Torregrosa
    • 3
  • Pilar Peris
    • 4
  • Ana Monegal
    • 4
  • Jose-Luis Bedini
    • 1
  • Maria-JesÚs Martinez De Osaba
    • 2
    • 5
  • Xavier Filella
    • 1
  • Gloria Martin
    • 3
  • Carmen Ricos
    • 6
  • Federico Oppenheimer
    • 3
  • Antonio-Manuel Ballesta
    • 1
  1. 1.Service of Clinical BiochemistryHospital ClÌnicSpain
  2. 2.Metabolic Bone Diseases UnitInstitut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) BarcelonaSpain
  3. 3.Renal Transplantation Unit, Hospital ClinicUniversity of BarcelonaBarcelonaSpain
  4. 4.Service of Rheumatology, Hospital ClinicUniversity of BarcelonaBarcelonaSpain
  5. 5.Hormonal Laboratory, Hospital ClinicUniversity of BarcelonaBarcelonaSpain
  6. 6.Laboratory Clinics Vall d’HebronHospital Vall d’HebronBarcelonaSpain

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