Title:Potential Role of Bone Metabolism Markers in Kidney Transplant
Recipients
Volume: 31
Issue: 19
关键词:
肾移植，血液透析，骨代谢，肾性骨营养不良，慢性肾脏疾病，生物标志物。
摘要:
Background: The impact of treatments, suppressing the immune system, persistent
hyperparathyroidism, and other risk factors on mineral and bone disorder (MBD)
after kidney transplantation is well-known. However, there is limited knowledge about
their effect on bone metabolism biomarkers. This study aimed to investigate the influence
of kidney transplant on these markers, comparing them to patients undergoing hemodialysis
and healthy individuals.
Methods: In this cross-sectional study, three groups were included: kidney transplant patients
(n = 57), hemodialysis patients (n = 26), and healthy controls (n = 31). Plasma concentrations
of various bone metabolism biomarkers, including Dickkopf-related protein
1, osteoprotegerin, osteocalcin, osteopontin, sclerostin, and fibroblast growth factor 23,
were measured. Associations between these biomarkers and clinical and laboratory data
were evaluated.
Results: A total of 114 patients participated. Transplant recipients had significantly lower
levels of Dickkopf-related protein 1, osteoprotegerin, osteocalcin, osteopontin, sclerostin,
and fibroblast growth factor 23 compared to hemodialysis patients. Alkaline phosphatase
levels positively correlated with osteopontin (r = 0.572, p < 0.001), while fibroblast
growth factor 23 negatively correlated with 25-hydroxyvitamin D (r = -0.531, p
= 0.019). The panel of bone biomarkers successfully predicted hypercalcemia (area under
the curve [AUC] = 0.852, 95% confidence interval [CI] = 0.679-1.000) and dyslipidemia
(AUC = 0.811, 95% CI 0.640-0.982) in transplant recipients.
Conclusion: Kidney transplantation significantly improves mineral and bone disorders
associated with end-stage kidney disease by modulating MBD markers and reducing
bone metabolism markers, such as Dickkopf-related protein 1, osteoprotegerin, osteocalcin,
osteopontin, and sclerostin. Moreover, the panel of bone biomarkers effectively
predicted hypercalcemia and dyslipidemia in transplant recipients.
