PMID- 23545236
OWN - NLM
STAT- MEDLINE
DCOM- 20140130
LR  - 20151119
IS  - 1872-9177 (Electronic)
IS  - 1769-7255 (Linking)
VI  - 9
IP  - 3
DP  - 2013 Jun
TI  - [Bone biomarkers in haemodialysis patients: bone alkaline phosphatase or 
      ss-Crosslaps?].
PG  - 154-9
LID - S1769-7255(13)00049-7 [pii]
LID - 10.1016/j.nephro.2013.02.006 [doi]
AB  - BACKGROUND: Bone turnover (BT) abnormalities are frequently observed in patients 
      with chronic kidney disease. Bone biopsy remains the gold standard for diagnosis; 
      however, its invasive nature has led to its decreased utilisation. The serum 
      parathyroid hormone (PTH) level is not a reliable bone marker (BM) for BT 
      assessment. The latest international recommendations suggest the use of total 
      alkaline phosphatase (t-ALP) or bone-specific alkaline phosphatase (b-ALP), but 
      not ss-CrossLaps (CTX). We compared b-ALP, t-ALP, and CTX levels in patients on 
      haemodialysis (HD). METHODS: All HD patients at a single institution following a 
      standard 3x4 to 3x5 hours schedule were included in the study, provided they were 
      free from liver disease. Serum intact PTH, t-ALP, b-ALP, and CTX values were 
      compared at baseline and after 18 months of treatment. A kinetic study was 
      performed for pre- and postdialysis CTX values over a 2-week period. We described 
      the longitudinal evolution of these BMs in two typical patients. RESULTS: A total 
      of 98 patients on HD (46% female) were evaluated. The mean age was 69.8+/-11 years 
      and the mean duration of dialysis was 54.4+/-61 months. At baseline, CTX (2.1+/-1 
      mug/L) correlated well with b-ALP (18+/-11 mug/L; r=0.64; P<0.001) and PTH (221+/-165 
      pg/mL; r=0.62; P<0.001). The changes in these values at 18 months were also 
      correlated (DeltaCTX compared with Deltab-ALP: r=0.51; P<0.001; Deltab-ALP compared with 
      DeltaPTH: r=0.37, P<0.01). b-ALP and t-ALP (245+/-132 U/L) were closely correlated 
      (r=0.78), as was their variation over 18 months (r=0.67), but t-ALP did not 
      correlate with PTH, and correlated poorly with CTX (r=0.38). The CTX reduction 
      ratio during standard dialysis was approximately 70 to 75% over each session, 
      although predialysis values remained stable. CONCLUSION: In HD patients, mean CTX 
      values are five times higher than the normal range. CTX appears to be an 
      alternative to b-ALP for assessing BT. b-ALP remains the standard BM, despite 
      being expensive, infrequently available in many laboratories, and not useful for 
      patients with liver disease.
CI  - Copyright (c) 2013 Association Societe de nephrologie. Published by Elsevier SAS. 
      All rights reserved.
FAU - Jean, Guillaume
AU  - Jean G
AD  - NEPHROCARE Tassin-Charcot, 7, avenue du Marechal-Foch, 69110 Sainte Foy-Les-Lyon, 
      France. guillaume-jean-crat@wanadoo.fr
FAU - Souberbielle, Jean-Claude
AU  - Souberbielle JC
FAU - Granjon, Samuel
AU  - Granjon S
FAU - Lorriaux, Christie
AU  - Lorriaux C
FAU - Hurot, Jean-Marc
AU  - Hurot JM
FAU - Mayor, Brice
AU  - Mayor B
FAU - Deleaval, Patrik
AU  - Deleaval P
FAU - Chazot, Charles
AU  - Chazot C
LA  - fre
PT  - English Abstract
PT  - Journal Article
TT  - Quels marqueurs osseux chez les patients hemodialyses: phosphatases alcalines 
      osseuses ou ss-CrossLaps?
DEP - 20130329
PL  - France
TA  - Nephrol Ther
JT  - Nephrologie & therapeutique
JID - 101248950
RN  - 0 (Biomarkers)
RN  - 0 (Parathyroid Hormone)
RN  - 0 (Peptide Fragments)
RN  - 0 (glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine)
RN  - 9007-34-5 (Collagen)
RN  - EC 3.1.3.1 (Alkaline Phosphatase)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Alkaline Phosphatase/*blood
MH  - Biomarkers/*blood
MH  - *Bone Remodeling
MH  - Bone and Bones/*enzymology
MH  - Collagen/*blood
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Parathyroid Hormone/*blood
MH  - Peptide Fragments/*blood
MH  - Prospective Studies
MH  - Renal Dialysis/*statistics & numerical data
MH  - Renal Insufficiency, Chronic/*blood/therapy
EDAT- 2013/04/03 06:00
MHDA- 2014/01/31 06:00
CRDT- 2013/04/03 06:00
PHST- 2012/12/05 00:00 [received]
PHST- 2013/02/13 00:00 [revised]
PHST- 2013/02/26 00:00 [accepted]
PHST- 2013/04/03 06:00 [entrez]
PHST- 2013/04/03 06:00 [pubmed]
PHST- 2014/01/31 06:00 [medline]
AID - S1769-7255(13)00049-7 [pii]
AID - 10.1016/j.nephro.2013.02.006 [doi]
PST - ppublish
SO  - Nephrol Ther. 2013 Jun;9(3):154-9. doi: 10.1016/j.nephro.2013.02.006. Epub 2013 
      Mar 29.