Nephrology Dialysis Transplantation, Vol 13, Issue 3 662-667, Copyright © 1998 by Oxford University Press
B Behnke, M Kemper, H Kruse and D Muller-Wiefel
Background: With the introduction of a new
immunoradiometric assay based on two monoclonal antibodies
(Tandem®-Ostase, Hybritech) the determination of bone alkaline
phosphatase (BAP) to evaluate bone metabolism in chronic renal failure has
become easier and more valid. Subjects and methods:
Using this test we investigated BAP in a total of 90 paediatric patients,
42 (9.2±5.5 years) with chronic renal failure on conservative
treatment, 22 (9.5±5.4 years) under chronic dialysis, and 26
(16.2±5.9 years) after renal transplantation, compared to 203
controls (10.1±5.7 years). Results: The
physiological age dependency found in controls including two peaks during
infancy and puberty was distinctly disturbed in chronic renal failure.
However, in patients BAP significantly correlated with height velocity
rather reflecting the last 6 (r=0.56 P<0.001) than the last 12
months. Although BAP correlated well with total alkaline phosphatase (TAP;
r=0.95 P<0.001), a significant correlation with the serum level of
the intact parathyroid hormone could only be detected for BAP (r=0.45
P<0.001) but not for TAP (R=0.19 N.S.) Furthermore, BAP positively
correlated with trabecular (n=40; r=0.40 P<0.05) and inversely with
cortical bone density (n=19; r=-0.58 P<0.01) but no relationship was
found with conventional X-ray. Conclusion: BAP
determined by the new radioimmunoassay seems to represent an additional
diagnostic tool to assess growth and bone turnover in paediatric patients
with chronic renal failure that is complementary to the information
provided by X-ray and total alkaline phosphatase. Key
words: bone alkaline phosphatase; children; chronic renal
failure
ORIGINAL ARTICLES
Bone alkaline phosphatase in children with chronic renal failure
Departments of Pediatrics and Nephrology and Osteology, Universitats-Kinderklinik, Hamburg-Eppendorf, D-20246 Hamburg, Germany; Corresponding author
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