Calcitropic hormonal status in north Indian patients with end-stage renal disease

Avneesh Singh, S. Avula, V. Kher, D. S. Rao, A. Mithal

Research output: Contribution to journalArticle

Abstract

Background. Bone disease in chronic renal failure has a wide spectrum that includes both high and low turnover conditions. Specific preventive and therapeutic measures require knowledge of the nature of bone involvement. Bone biopsy with static and dynamic histomorphometry Is the gold standard for characterization of renal bone disease. However, non-invasive biochemical tests, especially serum intact parathyroid hormone (PTH), have a good correlation with histomorphometry. We studied the clinical and biochemical profile of bone disease in a sample of north Indian patients with chronic renal failure. Methods. Twenty-nine patients of chronic renal failure were evaluated clinically, radiologically (subperiosteal erosions on hand X-rays) and biochemically (serum calcium, phosphorus, total alkaline phosphatase, intact PTH, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D). Bone histomorphometry could be done In 4 patients. Results. Serum intact PTH within or below the non-uraemic normal range, an index of low bone turnover, was seen in 17 (58.6%) patients. Serum osteocalcin, a bone formation marker, was within or below the non-uraemic normal range in 65.5% patients. Serum intact PTH and osteocalcin had a significant positive correlation (r=0.6). Patient groups with clinical or radiological evidence of bone disease had serum intact PTH and osteocalcin levels comparable to those lacking such features. Serum intact PTH and total alkaline phosphatase were lower in haemodialysed (n=25) patients than In those who had not received haemodialysis (n=4). Low (< 10 ng/ml) serum 25-hydroxyvitamin D levels were seen in 7 (24%) patients while 1,25-dihydroxyvitamin D was low (< 15.9 pg/ml) in 20 (69%) patients. The biochemical parameters accurately reflected the bone histology (n=4). Conclusions. Our data show that the majority of north Indian patients with chronic renal failure have biochemical evidence of low bone turnover. Empirical use of calcium salts and active vitamin D analogues without documentation of parathyroid status carry the risk of further suppression of bone turnover.

Original languageEnglish (US)
Pages (from-to)202-207
Number of pages6
JournalNational Medical Journal of India
Volume12
Issue number5
StatePublished - Sep 1 1999
Externally publishedYes

Fingerprint

Chronic Kidney Failure
Parathyroid Hormone
Bone Diseases
Osteocalcin
Serum
Bone Remodeling
Bone and Bones
Alkaline Phosphatase
Reference Values
Calcium
Osteogenesis
Vitamin D
Documentation
Phosphorus
Renal Dialysis
Histology
Hand
Salts
X-Rays
Kidney

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Calcitropic hormonal status in north Indian patients with end-stage renal disease. / Singh, Avneesh; Avula, S.; Kher, V.; Rao, D. S.; Mithal, A.

In: National Medical Journal of India, Vol. 12, No. 5, 01.09.1999, p. 202-207.

Research output: Contribution to journalArticle

Singh, Avneesh ; Avula, S. ; Kher, V. ; Rao, D. S. ; Mithal, A. / Calcitropic hormonal status in north Indian patients with end-stage renal disease. In: National Medical Journal of India. 1999 ; Vol. 12, No. 5. pp. 202-207.
@article{ed8dfc78d2854c80bf329c7724900e9e,
title = "Calcitropic hormonal status in north Indian patients with end-stage renal disease",
abstract = "Background. Bone disease in chronic renal failure has a wide spectrum that includes both high and low turnover conditions. Specific preventive and therapeutic measures require knowledge of the nature of bone involvement. Bone biopsy with static and dynamic histomorphometry Is the gold standard for characterization of renal bone disease. However, non-invasive biochemical tests, especially serum intact parathyroid hormone (PTH), have a good correlation with histomorphometry. We studied the clinical and biochemical profile of bone disease in a sample of north Indian patients with chronic renal failure. Methods. Twenty-nine patients of chronic renal failure were evaluated clinically, radiologically (subperiosteal erosions on hand X-rays) and biochemically (serum calcium, phosphorus, total alkaline phosphatase, intact PTH, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D). Bone histomorphometry could be done In 4 patients. Results. Serum intact PTH within or below the non-uraemic normal range, an index of low bone turnover, was seen in 17 (58.6{\%}) patients. Serum osteocalcin, a bone formation marker, was within or below the non-uraemic normal range in 65.5{\%} patients. Serum intact PTH and osteocalcin had a significant positive correlation (r=0.6). Patient groups with clinical or radiological evidence of bone disease had serum intact PTH and osteocalcin levels comparable to those lacking such features. Serum intact PTH and total alkaline phosphatase were lower in haemodialysed (n=25) patients than In those who had not received haemodialysis (n=4). Low (< 10 ng/ml) serum 25-hydroxyvitamin D levels were seen in 7 (24{\%}) patients while 1,25-dihydroxyvitamin D was low (< 15.9 pg/ml) in 20 (69{\%}) patients. The biochemical parameters accurately reflected the bone histology (n=4). Conclusions. Our data show that the majority of north Indian patients with chronic renal failure have biochemical evidence of low bone turnover. Empirical use of calcium salts and active vitamin D analogues without documentation of parathyroid status carry the risk of further suppression of bone turnover.",
author = "Avneesh Singh and S. Avula and V. Kher and Rao, {D. S.} and A. Mithal",
year = "1999",
month = "9",
day = "1",
language = "English (US)",
volume = "12",
pages = "202--207",
journal = "National Medical Journal of India",
issn = "0970-258X",
publisher = "All India Institute of Medical Sciences",
number = "5",

}

TY - JOUR

T1 - Calcitropic hormonal status in north Indian patients with end-stage renal disease

AU - Singh, Avneesh

AU - Avula, S.

AU - Kher, V.

AU - Rao, D. S.

AU - Mithal, A.

PY - 1999/9/1

Y1 - 1999/9/1

N2 - Background. Bone disease in chronic renal failure has a wide spectrum that includes both high and low turnover conditions. Specific preventive and therapeutic measures require knowledge of the nature of bone involvement. Bone biopsy with static and dynamic histomorphometry Is the gold standard for characterization of renal bone disease. However, non-invasive biochemical tests, especially serum intact parathyroid hormone (PTH), have a good correlation with histomorphometry. We studied the clinical and biochemical profile of bone disease in a sample of north Indian patients with chronic renal failure. Methods. Twenty-nine patients of chronic renal failure were evaluated clinically, radiologically (subperiosteal erosions on hand X-rays) and biochemically (serum calcium, phosphorus, total alkaline phosphatase, intact PTH, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D). Bone histomorphometry could be done In 4 patients. Results. Serum intact PTH within or below the non-uraemic normal range, an index of low bone turnover, was seen in 17 (58.6%) patients. Serum osteocalcin, a bone formation marker, was within or below the non-uraemic normal range in 65.5% patients. Serum intact PTH and osteocalcin had a significant positive correlation (r=0.6). Patient groups with clinical or radiological evidence of bone disease had serum intact PTH and osteocalcin levels comparable to those lacking such features. Serum intact PTH and total alkaline phosphatase were lower in haemodialysed (n=25) patients than In those who had not received haemodialysis (n=4). Low (< 10 ng/ml) serum 25-hydroxyvitamin D levels were seen in 7 (24%) patients while 1,25-dihydroxyvitamin D was low (< 15.9 pg/ml) in 20 (69%) patients. The biochemical parameters accurately reflected the bone histology (n=4). Conclusions. Our data show that the majority of north Indian patients with chronic renal failure have biochemical evidence of low bone turnover. Empirical use of calcium salts and active vitamin D analogues without documentation of parathyroid status carry the risk of further suppression of bone turnover.

AB - Background. Bone disease in chronic renal failure has a wide spectrum that includes both high and low turnover conditions. Specific preventive and therapeutic measures require knowledge of the nature of bone involvement. Bone biopsy with static and dynamic histomorphometry Is the gold standard for characterization of renal bone disease. However, non-invasive biochemical tests, especially serum intact parathyroid hormone (PTH), have a good correlation with histomorphometry. We studied the clinical and biochemical profile of bone disease in a sample of north Indian patients with chronic renal failure. Methods. Twenty-nine patients of chronic renal failure were evaluated clinically, radiologically (subperiosteal erosions on hand X-rays) and biochemically (serum calcium, phosphorus, total alkaline phosphatase, intact PTH, osteocalcin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D). Bone histomorphometry could be done In 4 patients. Results. Serum intact PTH within or below the non-uraemic normal range, an index of low bone turnover, was seen in 17 (58.6%) patients. Serum osteocalcin, a bone formation marker, was within or below the non-uraemic normal range in 65.5% patients. Serum intact PTH and osteocalcin had a significant positive correlation (r=0.6). Patient groups with clinical or radiological evidence of bone disease had serum intact PTH and osteocalcin levels comparable to those lacking such features. Serum intact PTH and total alkaline phosphatase were lower in haemodialysed (n=25) patients than In those who had not received haemodialysis (n=4). Low (< 10 ng/ml) serum 25-hydroxyvitamin D levels were seen in 7 (24%) patients while 1,25-dihydroxyvitamin D was low (< 15.9 pg/ml) in 20 (69%) patients. The biochemical parameters accurately reflected the bone histology (n=4). Conclusions. Our data show that the majority of north Indian patients with chronic renal failure have biochemical evidence of low bone turnover. Empirical use of calcium salts and active vitamin D analogues without documentation of parathyroid status carry the risk of further suppression of bone turnover.

UR - http://www.scopus.com/inward/record.url?scp=0033182146&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033182146&partnerID=8YFLogxK

M3 - Article

C2 - 10612998

AN - SCOPUS:0033182146

VL - 12

SP - 202

EP - 207

JO - National Medical Journal of India

JF - National Medical Journal of India

SN - 0970-258X

IS - 5

ER -