sRANKL/osteoprotegerin complex and biochemical markers in a cohort of male and female hemodialysis patients

Abstract

Lower values of sRANKL/OPG ratio in HD patients, as well as the age and duration of HD dependent increase of serum OPG and the age-dependent decrease of sRANKL concentration especially in women cannot be explained by the elimination of renal clearance only. Alterations in sRANKL/OPG ratio might reflect a compensatory mechanism to modulate bone remodeling in these patients.

OPG/RANK/RANKL signaling system and its significance in nephrology.

“…Another research by Avbersek-Luznik et al support hypothesis that PTH increases bone resorbtion in HD patients through stimulating RANKL synthesis [40]. Conversely, in Doumouchtsis study, the average serum concentration of sRANKL was lower in patients on HD than in age-matched healthy controls [36] .…”

“…Among HD patients, serum OPG level increased significantly with aging and with longer duration of HD. Increase in OPG with longer duration of HD may be related to stimulation by uremia, hemodialysis procedure itself, and drugs [36]. Kazamo et al reported that OPG is not removed through the polysulfon hemodialysis membrane.…”

“…OPG concentrations are reported to be higher in HD patients [35][36][37][38][39], whereas RANKL level can be higher [39,40], lower [36] or within normal range [41] compared to healthy individuals. Kazama showed that serum OPG levels in uremic patients were elevated and independent of their serum PTH levels, what suggested the circulating OPG to be an independent factor affecting bone metabolism in uremic patients [42].…”

“…This may be skeleton protective mechanism to compensate any perturbations in bone turnover in renal failure [36].…”

Influence of Parathyroidectomy on Bone Metabolism and Bone Pain in Patients with Secondary Hyperparathyroidism

“…The gold standard for detecting renal osteopathy would be histological bone examination through biopsy [11]. To prevent invasive measures, several studies have analyzed blood markers as noninvasive diagnostic options for identifying renal osteopathy [12-16]. …”