Document Detail

Association of serum alkaline phosphatase and bone mineral density in maintenance hemodialysis patients.
MedLine Citation:
PMID:  20345388     Owner:  NLM     Status:  MEDLINE    
Recent studies indicate that serum alkaline phosphatase (AlkPhos), a surrogate of high turnover bone disease, is associated with coronary artery calcification and death risk in maintenance hemodialysis (MHD) patients. The association between AlkPhos and bone mineral density (BMD) is not well studied. We studied the association between AlkPhos and dual-energy X-ray absorptiometry-assessed BMD in a group of MHD patients in Southern California. In 154 MHD patients, aged 55.3 +/- 13.6 years, including 42% women, 38% Hispanics, 42% African Americans, and 55% diabetics, the mean serum AlkPhos was 121 +/- 63 U/L (median: 101, Q(25-75): 81-141); 36% had AlkPhos>/=120 U/L and 50% had a total T-score< or =-1. Whereas the total BMD did not correlate with age (r=0.01, P=0.99) or body mass index (r=0.10, P=0.22), it correlated negatively with AlkPhos (r=-0.25, P=0.002), including after multivariate adjustment (r=-0.24, P=0.003). The proportion of patients with a high coronary artery calcification score>400 was incrementally higher across worsening BMD tertiles (P trend=0.04). The BMD was significantly worse in MHD patients with serum AlkPhos> or =120 U/L compared with <120 U/L (1.01 +/- 0.016 vs. 1.08 +/- 0.013 g/cm(2), respectively, P<0.001). The multivariate adjusted odds ratio of AlkPhos> or =120 U/L for having a total T-score<-1.0 was 2.3 (1.1-4.8, P=0.037). Among routine clinical and biochemical markers, serum AlkPhos> or =120 U/L was a better predictor of total T-score< or =-1 in MHD patients. An association exists between higher serum AlkPhos and worse dual-energy X-ray absorptiometry-assessed BMD in MHD patients. Given these findings, studies are indicated to examine whether interventions that lower serum AlkPhos improve BMD in MHD patients.
Jong Chan Park; Csaba P Kovesdy; Uyen Duong; Elani Streja; Mehdi Rambod; Allen R Nissenson; Stuart M Sprague; Kamyar Kalantar-Zadeh
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-03-24
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  14     ISSN:  1542-4758     ISO Abbreviation:  Hemodial Int     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-09-08     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  182-92     Citation Subset:  IM    
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MeSH Terms
Absorptiometry, Photon
Alkaline Phosphatase / blood*
Bone Density / physiology*
Bone Remodeling / physiology
Kidney Failure, Chronic / epidemiology,  metabolism*,  therapy*
Middle Aged
Predictive Value of Tests
Regression Analysis
Renal Dialysis*
Renal Osteodystrophy / diagnosis,  epidemiology,  metabolism*
Risk Factors
Grant Support
Reg. No./Substance:
EC Phosphatase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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