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Parathormone and bone-specific alkaline phosphatase for the follow-up of bone turnover in hemodialysis patients: is it so simple? | LitMetric

AI Article Synopsis

  • Chronic Kidney Disease (CKD) can lead to mineral and bone disorders, and guidelines suggest using serum parathormone (PTH) and bone-specific alkaline phosphatase (b-ALP) to assess these conditions in dialysis patients.
  • A study tracked changes in PTH and b-ALP levels over periods of 6 weeks and 1 year in a group of hemodialysis patients, finding correlations at baseline but no significant correlation for changes over time.
  • The results suggest a lack of consistent relationship between changes in PTH and b-ALP levels, highlighting the complexity of monitoring these biomarkers in CKD patients on hemodialysis.

Article Abstract

Background: Chronic Kidney Disease (CKD) is associated with mineral and bone disorders (MBD). International guidelines suggest that levels of serum parathormone (PTH) or bone-specific alkaline phosphatase (b-ALP) can be used to evaluate MBD in dialysis patients. The evidence remains moderate and based on transversal studies.

Methods: We retrospectively investigated the variations of PTH (ΔPTH) and b-ALP (Δb-ALP) serum concentrations over a short (6-weeks) and a long (one-year) period in a monocentric hemodialysis population. The proportion of patients reaching the critical difference (CD) (50% for PTH and 25% for b-ALP) was calculated.

Results: Seventy-seven patients were included. A significant correlation between PTH and b-ALP levels was found at baseline (r=0.51). By contrast, no correlation was observed between ΔPTH and Δb-ALP over a 6-week interval (r=0.07). The CD for PTH and b-ALP was reached by 19 and 11 patients, respectively, with 2 patients showing consistent variations of both biomarkers. One year later, measurements were repeated in 48 survivors. No correlation was found between ΔPTH and Δb-ALP (r=0.27). The CD for PTH or b-ALP was reached by 24 patients and 28 patients, respectively, with 6 patients (12.5%) showing opposite results for both biomarkers.

Conclusion: This study shows the lack of correlation between ΔPTH and Δb-ALP over time in patients under chronic hemodialysis.

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Source
http://dx.doi.org/10.1016/j.cca.2012.12.009DOI Listing

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