Evaluation of Renal Osteodystrophy and Serum Bone-Related Biomarkers in a Peritoneal Dialysis Population

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Luís Carlos Ferreira Mendonça

    Autor

  • Ricardo Morais Pereira Neto

    Autor

  • Janete Maria Quelhas Dos Santos

    Autor

  • João Miguel Machado Dória Frazão

    Autor

Participantes de fora da FMUP

  • Pereira, L
  • Magalhaes, J
  • Carvalho, CG
  • Oliveira, A
  • Beco, A

Unidades de investigação

Abstract

The spectrum of renal osteodystrophy (ROD) in peritoneal dialysis (PD) patients remains to be clarified. Ideal intact parathormone (iPTH) levels range is still not defined. The role of sclerostin, dickkopf-related protein 1, osteoprotegerin, and receptor activator for nuclear factor kappa B ligand for the diagnosis of ROD needs to be elucidated. In this cross-sectional study, tetracycline double-labeled bone biopsy was performed in 49 patients with histomorphometric analysis according Kidney Disease Improving Global Outcomes (KDIGO) guidelines. All patients were treated with biocompatible PD solutions, with calcium concentration of 1.25 mmol/L. Adynamic bone was the most frequent diagnosed pattern (42.9%) followed by hyperparathyroid-related bone disease (28.6%). Twenty-two percent of patients had normal bone. In patients with iPTH within the KDIGO recommended range for dialysis patients, adynamic bone was found in 59% of cases. Median (range) iPTH in patients with adynamic bone was 312 (60-631) pg/mL. Median (range) levels of sclerostin varied from 1511.64 (458.84-6387.70) pg/mL in patients with hyperparathyroid bone disease to 2433.1 (1049.59-11354.52) pg/mL in patients with adynamic bone. Sclerostin/iPTH ratio was the best marker of low turnover disease but iPTH performed best in the diagnosis of high turnover disease. Calcium mass transfer was positive in patients with low bone volume. Adynamic bone is the most frequent ROD pattern in contemporary PD. Our results suggest the need to review the iPTH target range for this population. The sclerostin/iPTH ratio showed improved performance compared to iPTH for the diagnosis of low turnover bone. (c) 2022 American Society for Bone and Mineral Research (ASBMR).

Dados da publicação

ISSN/ISSNe:
1523-4681, 0884-0431

Journal of Bone and Mineral Research  Wiley-Blackwell

Tipo:
Article
Páginas:
1689-1699
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 3

Citações Recebidas na Scopus: 9

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Keywords

  • RENAL OSTEODYSTROPHY; PERITONEAL DIALYSIS; BONE BIOPSY; ADYNAMIC BONE; BONE BIOMARKERS

Proyectos asociados

Update on the impact of sodium-glucose cotransporter inhibitors in diabetic kidney disease progression

Investigador Principal: Ricardo Morais Pereira Neto

Estudo Clínico Académico (Diabetic Kidney) . 2020

Novos Agentes Redutores de Potássio na Abordagem da Hipercalémia na Doença Renal Crónica

Investigador Principal: Ricardo Morais Pereira Neto

Estudo Clínico Académico . 2021

Kidney-induced osteoporosis: a new entity with a novel therapeutic approach.

Investigador Principal: João Miguel Machado Dória Frazão

Estudo Clínico Académico . 2020

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