Serum
osteocalcin has been found to correlate with bone formation. However, present literature gives only limited data on
osteocalcin and bone histomorphometry in patients undergoing
peritoneal dialysis. This study assessed serum
osteocalcin,
dialysate osteocalcin, peritoneal clearance of
osteocalcin (Clp-
osteocalcin) and mass transfer of
osteocalcin (MTp-
osteocalcin), and evaluated relationships between these values and bone histomorphometry. Eighteen patients were treated by
continuous ambulatory peritoneal dialysis (
CAPD). Bone biopsies, serum and
dialysate osteocalcin, serum levels of
parathyroid hormone,
alkaline phosphatase,
aluminum, phosphate, Ca2+ and
vitamin D3 metabolites were measured at the start and in 10 of the patients a year later. Serum
osteocalcin was found to be elevated.
Osteocalcin was detected in the
dialysate resulting in significant values of Clp-
osteocalcin and MTp-
osteocalcin. Serum and
dialysate levels of
osteocalcin correlated significantly (r = 0.66, P < 0.001) and like MTp-
osteocalcin with serum levels of
alkaline phosphatase and PTH. Histomorphometry showed that
osteitis fibrosa was the predominant
bone disease detected. Serum concentration of
osteocalcin correlated with osteoid thickness, eroded and osteoclast surfaces,
aluminum staining, and some of the bone dynamic parameters.
Dialysate osteocalcin, MTp-
osteocalcin, PTH and
alkaline phosphatase correlated with practically the same histomorphometric parameters as serum
osteocalcin. No correlations were seen between Clp-
osteocalcin and any histomorphometric parameters. Serum
osteocalcin was elevated above the normal range, and significant positive correlations between serum
osteocalcin and bone formation parameters were found. Serum
osteocalcin correlated with almost the same histomorphometric parameters as PTH. Thus, serum levels of PTH and
osteocalcin gave additional information to one another as non-invasive parameters in this group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)