Relationship between biochemical parameters of mineral bone disease and static bone histomorphometry in chronic kidney disease patients on hemodialysis: An Indian cross-section study

Abstract

Aim: We estimated the relationship between routine biochemical laboratory parameters with static bone histomorphometric parameters and their high and low bone turnover capacity predictability in hemodialysis patients. Method: It was a single-center cross-sectional study, included 28 hemodialysis patients. The routine biochemical parameters measured including calcium, phosphorous, alkaline phosphatase, intact PTH, and 25-hydroxycholecalciferol. The histomorphometric parameters assessed were osteoblasts perimeter, osteoclast perimeter, eroded perimeter, osteoid perimeter, bone fibrosis and bone volume. Result: Total 28 hemodialysis patients underwent bone biopsy. Seventy percent were male, with a mean age was 33.07 ± 10.42 yrs; serum alkaline phosphatase was 219.10 ± 311.3 IU/ml; vitamin D was 18.18 ± 9.56 ng/ml, and intact PTH was 650.7 ± 466.0 pg/ml. Intact PTH had a significant positive association with osteoblast, osteoclast, eroded surface, and osteoid perimeter. Serum alkaline phosphatase had a significant relationship with bone fibrosis (r = 0.525, p-value = 0.004). Intact PTH was significantly higher in females than males (1078.75 ± 533.04 vs. 479.6 ± 309.83; p-value = 0.004). The osteoid surface was significantly high in females compared to males (p = 0.038). Age had a significant impact on osteoblast and eroded surface (p = 0.008 and p = 0.031, respectively). Intact PTH is a reliable biomarkers for bone turnover compare to ALP (p < 0.001 and p = 0.554, respectively). Conclusion: Intact PTH strongly associated with bone formation, bone resorption parameters. Gender and age had significant impact on static histomorphometric parameters in our study.

Keywords

• Bone biopsy
• Bone turnover
• Chronic kidney disease
• Hemodialysis
• Parathyroid hormone
• Alkaline phosphatase