Relationship between biochemical parameters of mineral bone disease and static bone histomorphometry in chronic kidney disease patients on hemodialysis: An Indian cross-section study

Aim We estimated the relationship between routine biochemical laboratory parameters with static bone histomorphometric parameters and their high and low bone turnover capacity predictability in hemodialysis patients. Method It was a single-center cross-sectional study, included 28 hemodialysis patients. The routine biochemical parameters measured including calcium, phosphorous, alkaline phosphatase, intact PTH, and 25-hydroxycholecalciferol. The histomorphometric parameters assessed were osteoblasts perimeter, osteoclast perimeter, eroded perimeter, osteoid perimeter, bone fibrosis and bone volume. Result Total 28 hemodialysis patients underwent bone biopsy. Seventy percent were male, with a mean age was 33.07 +/- 10.42 yrs; serum alkaline phosphatase was 219.10 +/- 311.3 IU/ml; vitamin D was 18.18 +/- 9.56 ng/ml, and intact PTH was 650.7 +/- 466.0 pg/ml. Intact PTH had a significant positive association with osteoblast, osteoclast, eroded surface, and osteoid perimeter. Serum alkaline phosphatase had a significant relationship with bone fibrosis (r = 0.525, p-value = 0.004). Intact PTH was significantly higher in females than males (1078.75 +/- 533.04 vs. 479.6 +/- 309.83; p-value = 0.004). The osteoid surface was significantly high in females compared to males (p = 0.038). Age had a significant impact on osteoblast and eroded surface (p = 0.008 and p = 0.031, respectively). Intact PTH is a reliable biomarkers for bone turnover compare to ALP (p < 0.001 and p = 0.554, respectively). Conclusion Intact PTH strongly associated with bone formation, bone resorption parameters. Gender and age had significant impact on static histomorphometric parameters in our study. (c) 2023 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.