Diagnostic Accuracy of Bone Turnover Markers and Bone Histology in Patients With CKD Treated by Dialysis

Imagem de Miniatura
Arquivos
art_SPRAGUE_Diagnostic_Accuracy_of_Bone_Turnover_Markers_and_Bone_2016.PDF (389.5 KB)
Citações na Scopus
209
Tipo de produção
article
Data de publicação
2016
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
SPRAGUE, Stuart M.
BELLORIN-FONT, Ezequiel
CARVALHO, Aluizio B.
MALLUCHE, Hartmut H.
FERREIRA, Anibal
D'HAESE, Patrick C.
DRUEEKE, Tilman B.
DU, Hongyan
MANLEY, Thomas
Citação
AMERICAN JOURNAL OF KIDNEY DISEASES, v.67, n.4, p.559-566, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The management of chronic kidney disease-mineral and bone disorder requires the assessment of bone turnover, which most often is based on parathyroid hormone (PTH) concentration, the utility of which remains controversial. Study Design: Cross-sectional retrospective diagnostic test study. Setting & Participants: 492 dialysis patients from Brazil, Portugal, Turkey, and Venezuela with prior bone biopsy and stored (-20 degrees C) serum. Index Tests: Samples were analyzed for PTH (intact [iPTH] and whole PTH), bone-specific alkaline phosphatase (bALP), and amino-terminal propeptide of type 1 procollagen (P1NP). Reference Test: Bone histomorphometric assessment of turnover (bone formation rate/bone surface [BFR/BS]) and receiver operating characteristic curves for discriminating diagnostic ability. Results: The biomarkers iPTH and bALP or combinations thereof allowed discrimination of low from nonlow and high from nonhigh BFR/BS, with an area under the receiver operating characteristic curve > 0.70 but < 0.80. Using iPTH level, the best cutoff to discriminate low from nonlow BFR/BS was <103.8 pg/mL, and to discriminate high from nonhigh BFR/BS was >323.0 pg/mL. The best cutoff for bALP to discriminate low from nonlow BFR/BS was <33.1 U/L, and for high from nonhigh BFR/BS, 42.1 U/L. Using the KDIGO practice guideline PTH values of greater than 2 but less than 9 times the upper limit of normal, sensitivity and specificity of iPTH level to discriminate low from nonlow turnover bone disease were 65.7% and 65.3%, and to discriminate high from nonhigh were 37.0% and 85.8%, respectively. Limitations: Cross-sectional design without consideration of therapy. Potential limited generalizability with samples from 4 countries. Conclusions: The serum biomarkers iPTH, whole PTH, and bALP were able to discriminate low from nonlow BFR/BS, whereas iPTH and bALP were able to discriminate high from nonhigh BFR/BS. Prospective studies are required to determine whether evaluating trends in biomarker concentrations could guide therapeutic decisions. (C) 2016 by the National Kidney Foundation, Inc.
Palavras-chave
Sensitivity and specificity, alkaline phosphatases, bone-specific alkaline phosphatase (bALP, BSAP), bone histomorphometry, chronic kidney disease-mineral bone disorder (CKD-MBD), parathyroid hormone (PTH), procollagen type 1 N propeptide (P1NP), renal osteodystrophy
URI
https://observatorio.fm.usp.br/handle/OPI/14466
Referências
  1. Lehmann G, 2008, CLIN NEPHROL, V70, P296
  2. YOUDEN WJ, 1950, CANCER, V3, P32, DOI 10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3
  3. Monier-Faugere MC, 2001, KIDNEY INT, V60, P1460, DOI 10.1046/j.1523-1755.2001.00949.x
  4. Souberbielle JC, 2006, KIDNEY INT, V70, P345, DOI 10.1038/sj.ki.5001606
  5. Gardham C, 2010, CLIN J AM SOC NEPHRO, V5, P1261, DOI 10.2215/CJN.09471209
  6. Tomiyama C, 2010, J BONE MINER RES, V25, P499, DOI 10.1359/jbmr.090735
  7. SHERRARD DJ, 1993, KIDNEY INT, V43, P436, DOI 10.1038/ki.1993.64
  8. Asci G, 2011, NEPHROL DIAL TRANSPL, V26, P1010, DOI 10.1093/ndt/gfq491
  9. Moe S, 2006, KIDNEY INT, V69, P1945, DOI 10.1038/sj.ki.5000414
  10. Malluche HH, 2011, J BONE MINER RES, V26, P1368, DOI 10.1002/jbmr.309
  11. HRUSKA KA, 1995, NEW ENGL J MED, V333, P166
  12. Coresh J, 2007, JAMA-J AM MED ASSOC, V298, P2038, DOI 10.1001/jama.298.17.2038
  13. SALUSKY IB, 1994, KIDNEY INT, V45, P253, DOI 10.1038/ki.1994.31
  14. Adragao T, 2009, CLIN J AM SOC NEPHRO, V4, P450, DOI 10.2215/CJN.01870408
  15. Moe SM, 2005, NEPHROL DIAL TRANSPL, V20, P2186, DOI 10.1093/ndt/gfh966
  16. Malluche HH, 2006, CLIN NEPHROL, V65, P235
  17. Tentori F, 2008, AM J KIDNEY DIS, V52, P519, DOI 10.1053/j.ajkd.2008.03.020
  18. Herberth J, 2010, AM J KIDNEY DIS, V55, P897, DOI 10.1053/j.ajkd.2009.12.041
  19. Nickolas TL, 2013, J BONE MINER RES, V28, P1811, DOI 10.1002/jbmr.1916
  20. Barreto DV, 2008, AM J KIDNEY DIS, V52, P1139, DOI 10.1053/j.ajkd.2008.06.024
  21. Filgueira A, 2011, CLIN J AM SOC NEPHRO, V6, P1456, DOI 10.2215/CJN.10061110
  22. Bervoets ARJ, 2003, AM J KIDNEY DIS, V41, P997, DOI 10.1016/S0272-6386(03)00197-5
  23. Wesseling-Perry K, 2009, J CLIN ENDOCR METAB, V94, P511, DOI 10.1210/jc.2008-0326
  24. Gal-Moscovici A, 2010, KIDNEY INT, V78, P146, DOI 10.1038/ki.2010.113
  25. Sprague SM, 2013, CLIN J AM SOC NEPHRO, V8, P313, DOI 10.2215/CJN.04650512
  26. Herberth J, 2009, CLIN NEPHROL, V72, P5
  27. QI QL, 1995, AM J KIDNEY DIS, V26, P622, DOI 10.1016/0272-6386(95)90599-5
  28. Moorthi RN, 2013, KIDNEY INT, V84, P886, DOI 10.1038/ki.2013.254
  29. Bakkaloglu SA, 2010, CLIN J AM SOC NEPHRO, V5, P1860, DOI 10.2215/CJN.01330210
  30. Couttenye MM, 1996, NEPHROL DIAL TRANSPL, V11, P1065
  31. Hosmer DW, 2000, APPL LOGISTIC REGRES, P143
  32. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group, 2009, KIDNEY INT S, V113, pS1 , DOI 10.1038/KI.2009.188
  33. Malluche HH, 1986, ATLAS MINERALIZED BO
  34. National Kidney Foundation, 2003, AM J KIDNEY DIS S, V42, pS1, DOI 10.1016/S0272-6386(03)00905-3
  35. Zhang QL, 2008, BMC PUBLIC HEALTH, V8, DOI 10.1186/1471-2458-8-117

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/16
Artigos e Materiais de Revistas Científicas - ODS/03