Comparison of Biochemical Markers of Bone Turnover in Patients on Continuous Ambulatory Peritoneal Dialysis and Maintenance Hemodialysis

摘要

Comparison of Biochemical Markers of Bone Turnover in Patients on Continuous Ambulatory Peritoneal Dialysis and Maintenance HemodialysisThe aim of this study was to compare the biochemical markers of bone formation - bone isoenzyme alkaline phosphatase, /BALP/ bone resorption - tartarat resistant acid phosphatase /TRAP/ and parameters of bone turnover (Ca, P and iPTH) between 108 patients on continuous ambulatory peritoneal dialysis (CAPD) and 112 patients on hemodialysis (HD). Parameters were determined by spectrophotometry (TRAP, Ca, P), electrochemiluminiscent method (iPTH) and electrophoresis (BALP). There was significant correlation between BALP levels of CAPD patients and Ca values of HD patients (r = 0.216, p < 0.05), but comparison of P, iPTH and BALP showed no significant difference between the groups. We found significant correlation between BALP and TRAP (r = 0.570, p < 0.01) and BALP and iPTH values (r = 0.551, p < 0.01) in HD patients. Also, significant correlations in CAPD patients between BALP and TRAP (r = 0.194, p < 0.05) and BALP and iPTH values (r = 0.283, p < 0.01) were found. Our results suggest that the effect of CAPD and HD on bone turnover may be monitored most conclusively via BALP levels. This biochemical marker is a very good index of bone turnover in patients undergoing dialysis and it could indicate an early stage of decreased bone turnover.