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Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease

OBJECTIVES: The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chronic...

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Autores principales: Doyon, Anke, Fischer, Dagmar-Christiane, Bayazit, Aysun Karabay, Canpolat, Nur, Duzova, Ali, Sözeri, Betül, Bacchetta, Justine, Balat, Ayse, Büscher, Anja, Candan, Cengiz, Cakar, Nilgun, Donmez, Osman, Dusek, Jiri, Heckel, Martina, Klaus, Günter, Mir, Sevgi, Özcelik, Gül, Sever, Lale, Shroff, Rukshana, Vidal, Enrico, Wühl, Elke, Gondan, Matthias, Melk, Anette, Querfeld, Uwe, Haffner, Dieter, Schaefer, Franz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319910/
https://www.ncbi.nlm.nih.gov/pubmed/25659076
http://dx.doi.org/10.1371/journal.pone.0113482
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author Doyon, Anke
Fischer, Dagmar-Christiane
Bayazit, Aysun Karabay
Canpolat, Nur
Duzova, Ali
Sözeri, Betül
Bacchetta, Justine
Balat, Ayse
Büscher, Anja
Candan, Cengiz
Cakar, Nilgun
Donmez, Osman
Dusek, Jiri
Heckel, Martina
Klaus, Günter
Mir, Sevgi
Özcelik, Gül
Sever, Lale
Shroff, Rukshana
Vidal, Enrico
Wühl, Elke
Gondan, Matthias
Melk, Anette
Querfeld, Uwe
Haffner, Dieter
Schaefer, Franz
author_facet Doyon, Anke
Fischer, Dagmar-Christiane
Bayazit, Aysun Karabay
Canpolat, Nur
Duzova, Ali
Sözeri, Betül
Bacchetta, Justine
Balat, Ayse
Büscher, Anja
Candan, Cengiz
Cakar, Nilgun
Donmez, Osman
Dusek, Jiri
Heckel, Martina
Klaus, Günter
Mir, Sevgi
Özcelik, Gül
Sever, Lale
Shroff, Rukshana
Vidal, Enrico
Wühl, Elke
Gondan, Matthias
Melk, Anette
Querfeld, Uwe
Haffner, Dieter
Schaefer, Franz
author_sort Doyon, Anke
collection PubMed
description OBJECTIVES: The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chronic kidney disease cohort. METHODS: Bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRAP5b), sclerostin and C-terminal FGF-23 (cFGF23) normalized for age and sex were analyzed in 556 children aged 6–18 years with an estimated glomerular filtration rate (eGFR) of 10–60 ml/min/1.73m(2). 41 children receiving recombinant growth hormone therapy were compared to an untreated matched control group. RESULTS: Standardized levels of BAP, TRAP5b and cFGF-23 were increased whereas sclerostin was reduced. BAP was correlated positively and cFGF-23 inversely with eGFR. Intact serum parathormone was an independent positive predictor of BAP and TRAP5b and negatively associated with sclerostin. BAP and TRAP5B were negatively affected by increased C-reactive protein levels. In children receiving recombinant growth hormone, BAP was higher and TRAP5b lower than in untreated controls. Sclerostin levels were in the normal range and higher than in untreated controls. Serum sclerostin and cFGF-23 independently predicted height standard deviation score, and BAP and TRAP5b the prospective change in height standard deviation score. CONCLUSION: Markers of bone metabolism indicate a high-bone turnover state in children with chronic kidney disease. Growth hormone induces an osteoanabolic pattern and normalizes osteocyte activity. The osteocyte markers cFGF23 and sclerostin are associated with standardized height, and the markers of bone turnover predict height velocity.
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spelling pubmed-43199102015-02-18 Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease Doyon, Anke Fischer, Dagmar-Christiane Bayazit, Aysun Karabay Canpolat, Nur Duzova, Ali Sözeri, Betül Bacchetta, Justine Balat, Ayse Büscher, Anja Candan, Cengiz Cakar, Nilgun Donmez, Osman Dusek, Jiri Heckel, Martina Klaus, Günter Mir, Sevgi Özcelik, Gül Sever, Lale Shroff, Rukshana Vidal, Enrico Wühl, Elke Gondan, Matthias Melk, Anette Querfeld, Uwe Haffner, Dieter Schaefer, Franz PLoS One Research Article OBJECTIVES: The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chronic kidney disease cohort. METHODS: Bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRAP5b), sclerostin and C-terminal FGF-23 (cFGF23) normalized for age and sex were analyzed in 556 children aged 6–18 years with an estimated glomerular filtration rate (eGFR) of 10–60 ml/min/1.73m(2). 41 children receiving recombinant growth hormone therapy were compared to an untreated matched control group. RESULTS: Standardized levels of BAP, TRAP5b and cFGF-23 were increased whereas sclerostin was reduced. BAP was correlated positively and cFGF-23 inversely with eGFR. Intact serum parathormone was an independent positive predictor of BAP and TRAP5b and negatively associated with sclerostin. BAP and TRAP5B were negatively affected by increased C-reactive protein levels. In children receiving recombinant growth hormone, BAP was higher and TRAP5b lower than in untreated controls. Sclerostin levels were in the normal range and higher than in untreated controls. Serum sclerostin and cFGF-23 independently predicted height standard deviation score, and BAP and TRAP5b the prospective change in height standard deviation score. CONCLUSION: Markers of bone metabolism indicate a high-bone turnover state in children with chronic kidney disease. Growth hormone induces an osteoanabolic pattern and normalizes osteocyte activity. The osteocyte markers cFGF23 and sclerostin are associated with standardized height, and the markers of bone turnover predict height velocity. Public Library of Science 2015-02-06 /pmc/articles/PMC4319910/ /pubmed/25659076 http://dx.doi.org/10.1371/journal.pone.0113482 Text en © 2015 Doyon et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Doyon, Anke
Fischer, Dagmar-Christiane
Bayazit, Aysun Karabay
Canpolat, Nur
Duzova, Ali
Sözeri, Betül
Bacchetta, Justine
Balat, Ayse
Büscher, Anja
Candan, Cengiz
Cakar, Nilgun
Donmez, Osman
Dusek, Jiri
Heckel, Martina
Klaus, Günter
Mir, Sevgi
Özcelik, Gül
Sever, Lale
Shroff, Rukshana
Vidal, Enrico
Wühl, Elke
Gondan, Matthias
Melk, Anette
Querfeld, Uwe
Haffner, Dieter
Schaefer, Franz
Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease
title Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease
title_full Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease
title_fullStr Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease
title_full_unstemmed Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease
title_short Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease
title_sort markers of bone metabolism are affected by renal function and growth hormone therapy in children with chronic kidney disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319910/
https://www.ncbi.nlm.nih.gov/pubmed/25659076
http://dx.doi.org/10.1371/journal.pone.0113482
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