SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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S Ivanković1 , D Pavlović2 , V Rumenjak1

1Department for medical laboratory diagnosis and transfuziology, Sveti Duh General hospital, Zagreb, Croatia, 2Department for nephrology and dialysis, Clinical hospital „Sestre milosrdnice“ Zagreb, Croatia

Renal bone disease (renal osteodystrophy) is a common complication in patients with chronic renal failure. The aim of this study was to investigate the correlation between the serum concentrations of bone formation and bone resorption markers in renal patients undergoing the chronic dialysis (CD).
Patients and methods: N-MID Osteocalcin (N-MID-O), β-CrossLaps (β-CTx) and intact parathyroid hormone (PTH) were measured in serum of 42 patients undergoing CD (26 male and 16 female, aged 32 – 83 yrs, duration of CD: 5 to 288 months). The control group consisted of 30 people (19 female and 11 male, aged 30 – 67 yrs) without any sign of renal disease and/or hyperparathyroidism. All parameters were measured with electrochemiluminescence immunoassays (ECLIA) on the automated analyzer Elecsys 1010 (Roche Diagnostics).
Results: The N-MID-O, PTH and β-CTx values in patients undergoing CD were significantly (p < 0,001) higher vs. control group. According to the measured values of bone markers, we identified three groups : (I) the serum PTH values between 1,6–7,9 pmol/L, and N-MID-O (mean±SD) 155±83 μg/L and β-CTx 1516 ± 1022 pg/ml; (II) the serum PTH values between 8,0–30 pmol/L. The N-MID-O values in this group were 224±137 μg/L , and the β-CTx values were 1733±763 pg/ml; (III) the serum PTH values between 36–263 pmol/L: the N-MID-O values were 909±593 μg/L, and the β-CTx values were 3446±909 pg/ml.
There were the positive correlations between the PTH and the N-MID-O values (r=0,82 p < 0,05), and between the N-MID-O and the β-CTx values (r=0,80, p < 0,05) in patients undergoing CD. Patients with the PTH >36 pmol/L (group III) had significantly (p < 0,05) higher the N-MID-O and the β-CTx values than patients in groups (I) and (II).
Conclusion: The determinations of the N-MID-O and β-CTx levels indicate high turnover bone disease and could be useful biochemical bone markers in monitory of patients undergoing CD.


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