engleski

Predictors of bone disorder in chronic dialysis patients – investigation by bone markers.

Metabolic bone disease and osteopenia occur in most patients on chronic dialysis treatment. In this study clinical data were related to measurements of bone resorption marker, PTH and osteoprotegerin in patients on chronic dialysis treatment in order to investigate predictors of this bone disorder. This study comprised 79 patients (50 m, 29 f) ; dialysis duration was 6-341 months and age 24-83 years. The following biochemical parameters were measured by commercial methods in serum: C-terminal telopeptide of collagen I (CTX), intact PTH and osteoprotegerin (OPG). The results did not differ between genders, except higher osteoprotegerin in women. Increased CTX was found in 61/79 patients, and increased PTH in 23/79 patients (>3x normal reference limit). Statistically significant correlations showed that CTX decreased and OPG increased with age (p<0.0005), and dialysis duration correlated positively with PTH (p<0.03). CTX correlated positively with PTH (p<0.004) and negatively with OPG (p<0.005). Dialysis duration and PTH levels contributed to increased bone resorption. With regard to age bone resorption decreased and OPG increased. The predictors of increased bone resorption in patients on chronic dialysis were duration of replacement therapy, PTH secretion and possibly younger age. Bone resorption was less pronounced in older patients, also observed in higher OPG levels. This could be due to lower PTH levels in most of the older patients, although no correlation existed.

bone markers; bone metabolism; renal osteodystrophy; osteoprotegerin

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