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The N-terminal propeptide of type I procollagen-(PINP ) and Tartrate resistant acid phosphatase-(TRAP-5b) as bone turnover markers in dialysed patients

Calcif Tisse Int 72, Abstract P19

Nowak Z, Konieczna M, Wankowicz Z

Central Hospital of Military Institute of Medicine, Warsaw, Poland

Abstract

Non invasive measurement of bone turnover markers especially PINP and TRAP 5b has been considered as a potentially useful tool of diagnosis of renal osteodystrophy (ROD) in dialysed patients.

The aim of the study was to compare clinical usefulness of PINP and TRAP 5b with the standard marker of ROD which is iPTH.

We studied 80 patients: 58 on hemodialysis (HD) for 43 ± 25 months (36M, 22F aged 59 ± 25 yr.) and 22 on continuous ambulatory peritoneal dialysis (CAPD) for 47 ± 28 months (11M. 11F, aged 53 ± 23 yr.). According to the level of iPTH the whole group was divided in 3 subgroups: low (group1), medium (group2) and high turnover (group3) ROD.

The following parameters were determined in serum: PINP, TRAP 5b, iPTH, Ca, P. PINP was measured using radioimmuno assay (Orion Diagnostica Finland); TRAP 5b activity was measured using assay Bone TRAP(SBA Finland). Intact PTH was measured using immunoradiometric assay (Incstar USA).

We found significant correlation between iPTH and PINP (r= 0,7124; p<0,001) and between iPTH and TRAP (r= 0,6872, p < 0,001). In patients with high turnover ROD-(group 3.) significantly higher values of PINP and TRAP were found in comparison with group 1 of patients with low turnover ROD.(42 ± 20 vs.283 ± 138 p<0,001 and 7,3 ± vs. 2,8 ± p < 0,001 respectively). There ware not significant differences between values of, P, Ca in group1. vs. group 3. We also didn't find significant correlation between values of PINP, TRAP and gender, age and method of dialysotherapy.

In conclusion this results indicate the usefulness of PINP and TRAP 5b as markers of bone turnover in dialysed patients.