Bone turnover markers predict type of bone histomorphometry and bone mineral density in Asian chronic haemodialysis patients

• DOI: 10.1111/nep.13593
• Publication Date: 2019-04-13T09:43:56Z
• Authors: Suthanit Laowalert; Tanatorn Khotaviv...; Lalita Wattanachanya; Pobe Luangjarmekorn; Suwasin Udomkarnj...; Pisut Katavetin; Somchai Eiam‐Ong; Kearkiat Praditpo...; Paweena Susantita...
• Keywords: Bone remodeling; Bone histomorphometry; Iliac crest

ABSTRACT Background Although the levels of intact parathyroid hormone (iPTH) are well‐controlled following Kidney Disease Outcomes Quality Initiative guideline, incidence osteoporosis and fracture still high in haemodialysis (HD) patients. This study was conducted to investigate correlation between bone turnover markers, mineral density (BMD), histomorphometry HD Methods Twenty‐two chronic patients were enrolled. Serum markers measured. Double tetracycline‐labelled iliac crest specimens evaluated using specialized a computer program (Osteomeasure). The types classified based on turnover, mineralization volume. BMD coronary artery calcification also determined. Results Bone revealed osteitis fibrosa (50%), adynamic disease (45%) mixed uremic osteodystrophy (5%). iPTH level predicted with area under receiver operating characteristic (ROC) 0.833 (95% CI = 0.665–1.000, P 0.008). TRAP‐5b had ROC 0.733 0.517–0.950, 0.065). In addition, when serum (cut‐off 484.50 ng/mL) or 1.91 pg./mL) predict sensitivity 0.917. On other hand, both TRAP‐5B above these cut‐off, specificity 1.000. Low severe vascular commonly identified. However, there no significant correlations biomarkers calcification. Conclusion close target abnormal histomorphometry, BMD, common. biopsy is crucially required as an accurate diagnostic tool providing optimal guide for treatment. © 2019 Asian Pacific Society Nephrology