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Horm Metab Res 2017; 49(08): 618-624
DOI: 10.1055/s-0043-112349
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Varying Patterns of Biomarkers of Mineral and Bone Metabolism After Kidney Transplantation

Agnieszka Makówka
1   Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
,
Maciej Głyda
2   Department of Transplant Surgery with Urology Subdivision, Regional Hospital, Poznan, Poland
,
Ewa-Rutkowska Majewska
1   Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
,
Michał Nowicki
1   Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland
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Publikationsverlauf

received 08. Dezember 2016

accepted 23. Mai 2017

Publikationsdatum:
05. Juli 2017 (online)

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Abstract

Sclerostin inhibits Wnt/β-catenin signaling pathway, thereby decreasing bone formation. Osteoblast stimulating actions of parathyroid hormone (PTH) are mediated by suppression of sclerostin. Thus, sclerostin may reflect both bone metabolism and parathyroid function. The study was aimed to analyze the patterns of the changes of mineral and bone biomarkers for 9 months following kidney transplantation (KTx). Thirty-five patients after KTx were included into a 9-month observational study. Serum creatinine, calcium, phosphorus, 25-OH vitamin D, PTH, fibroblast growth factor 23 (FGF-23), sclerostin, and bone-specific alkaline phosphatase (BAP) were measured before KTx, and 1, 2 weeks, and 1, 2, 3, 4, 5, 6, and 9 months thereafter. Urine sclerostin/creatinine ratio was assessed in parallel from month 1 after KTx. Following KTx most serum markers significantly decreased till the end of observation including PTH (by 58%), phosphorus (37%), sclerostin (31%), BAP (28%), and FGF-23 (82%). Most of the decrease was observed during first 2 months after KTx. Serum calcium was increased by 17%. Urine sclerostin/creatinine ratio increased from month 1 till month 6. At KTx serum FGF-23 correlated only with phosphate (r=0.62, p=0.01) and PTH with BAP (r=0.49, p=0.04) but not with sclerostin. At the end of the study neither serum sclerostin nor FGF-23 correlated with other parameters of mineral and bone metabolism. Sclerostin shows the limited utility as the marker of the resolution of bone and mineral metabolism after KTx.

Key words

kidney transplantation - chronic kidney disease - mineral bone disorder - sclerostin - fibroblast growth factor–23 - secondary hyperparathyroidism
 

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