sRANKL/osteoprotegerin complex and biochemical markers in a cohort of male and female hemodialysis patients

sRANKL/osteoprotegerin complex and biochemical markers in a cohort of male and female hemodialysis patients

The processes involved in bone remodeling are under the control of a multitude of systemic and local factors. Receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoprotegerin (OPG) complex seems to be one of the major modulators of bone remodeling. In chronic renal failure, the cytokine sy...

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Published in:Journal of endocrinological investigation Vol. 30; no. 9; pp. 762 - 766
Main Authors: Doumouchtsis, K K, Kostakis, A I, Doumouchtsis, S K, Tziamalis, M P, Tsigris, C, Kostaki, M A, Perrea, D N
Format: Journal Article
Language:English
Published: Italy 01-10-2007
Subjects:
Acid Phosphatase - blood
Adult
Age Factors
Aged
Aged, 80 and over
Alkaline Phosphatase - blood
Biomarkers - blood
Bone Remodeling - physiology
Case-Control Studies
Cohort Studies
Female
Humans
Isoenzymes - blood
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - therapy
Male
Middle Aged
Osteocalcin - blood
Osteoprotegerin - blood
RANK Ligand - blood
Renal Dialysis
Sex Factors
Tartrate-Resistant Acid Phosphatase
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Summary:The processes involved in bone remodeling are under the control of a multitude of systemic and local factors. Receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoprotegerin (OPG) complex seems to be one of the major modulators of bone remodeling. In chronic renal failure, the cytokine systems involved in the regulation of bone turnover may be influenced, and are therefore likely to contribute to the pathogenesis of renal bone disease. The aim of the present study was the evaluation of RANKL/OPG complex in concert with other biochemical parameters in hemodialysis (HD) patients and the investigation of possible correlations between the serum levels of its components and several clinical parameters of these patients. We measured serum levels of intact PTH (iPTH), total serum RANKL (sRANKL), osteoprotegerin (OPG), alkaline phosphatase, osteocalcin (OC), and tartrate-resistant acid phosphatase (TRAP) in 104 HD patients and in 40 healthy controls. The average serum OPG level was significantly higher, whereas the average serum concentration of RANKL was nonsignificantly lower in patients on HD therapy than in age-matched healthy controls. Consequently, the mean sRANKL/OPG ratio was significantly lower in patients. Among HD patients, serum level of OPG increased significantly with aging and with a longer duration of hemodialysis. RANKL levels were inversely correlated with age nonsignificantly in the whole group of patients and significantly in the female subgroup (r=-0.322, p=0.035), whereas RANKL/OPG ratio declined significantly with age in the entire cohort of patients (r=-0.259, p=0.008). In addition, iPTH, OC, TRAP were significantly higher in female, whereas RANKL/OPG ratio was significantly higher in male than female patients. Lower values of sRANKL/OPG ratio in HD patients, as well as the age and duration of HD dependent increase of serum OPG and the age-dependent decrease of sRANKL concentration especially in women cannot be explained by the elimination of renal clearance only. Alterations in sRANKL/OPG ratio might reflect a compensatory mechanism to modulate bone remodeling in these patients.
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ISSN:0391-4097
1720-8386
DOI:10.1007/BF03350814