In this study we investigated the value of
biochemical markers of bone turnover in the diagnosis of
renal osteodystrophy in dialysis patients. The study was carried out in 22
chronic renal failure patients (mean age: 16.1 +/- 4.5) being treated with chronic dialysis. There were three groups according to intact
parathormone (iPTH) levels: Group I (n: 6): iPTH levels were less than 200 pg/ml; Group II (n: 9): iPTH levels were between 201 and 500 pg/ml; and Group III (n: 7). iPTH levels were higher than 501 pg/ml. We investigated iPTH, bone
alkaline phosphatase, total serum
alkaline phosphatase,
osteocalcin, serum type 1
procollagen peptide (
PICP) and
insulin-like growth factor-1 (IGF-1) levels in all patients. In group III mean bone
alkaline phosphatase level (126.0 +/- 10.95) was significantly higher than in both group I and group II (52.16 +/- 22.8, 57.35 +/- 16.21) (p < 0.001). Mean
osteocalcin level (35.13 +/- 2.93) in group I was significantly lower than in group III (40.52 +/- 2.83) (p < 0.05). Serum
alkaline phosphatase,
PICP and
IGF-1 levels were not different between the groups (p > 0.05). There was a significant positive correlation between bone
alkaline phosphatase and iPTH (r = 0.80, p < 0.0001). Serum
osteocalcin correlated with both bone
alkaline phosphatase and iPTH (correlation) coefficients were r = 0.44 and r = 0.51 respectively, p < 0.05). It is concluded that bone
alkaline phosphatase and osteoocalcin combined with iPTH level seem to be useful noninvasive markers of bone metabolism in dialysis patients.