Nephrol Dial Transplant (2002) 17: 233-238
© 2002 European Renal Association-European Dialysis and Transplant Association
Rapid Communication
Serum osteoprotegerin and renal osteodystrophy
1 Department of Nephrology, Second Medical Faculty, 2 Department of Experimental Medicine and Pathology, First Medical Faculty, La Sapienza University, 3 Department of Nephrology and Dialysis, San Giovanni Hospital, Rome, and 4 GB Grassi Hospital, Ostia, Italy
Abstract
Background. Numerous growth factors and cytokines are known to modulate bone turnover. An important, recently discovered complex involved in osteoclastogenesis is the osteoprotegerin/osteoprotegerin-ligand (OPG/OPGL) cytokine complex, which is produced by osteoblasts. Many factors, including parathyroid hormone (PTH), appear to affect bone turnover through this pathway. In this disorder, the role of the OPG/OPGL system in the pathogenesis of renal osteodystrophy, a disease with either low or high bone turnover, has not been investigated so far.
Methods. Thirty-nine chronic haemodialysis patients had bone biopsies, including histomorphometric and histodynamic examinations. In addition, the following serum biochemistry parameters were measured: serum OPG, intact PTH, PTH 1–84, total PTH, osteocalcin, total and bone alkaline phosphatases, 25-hydroxycholecalciferol and 1,25-dihydroxycholecalciferol.
Results. On average, serum OPG levels were above the normal range. They were lower in adynamic bone disease (ABD) patients, than in patients with predominant hyperparathyroidism (HP) or mixed osteodystrophy (MO). Significant negative correlations were found between serum OPG and PTH levels, and between serum OPG and parameters of bone resorption (ES/BS) and bone formation (ObS/BS and BFR/BS) in HP and MO patients with PTH values 
1000 pg/ml. For intact PTH levels 300 pg/ml, serum OPG was significantly lower in the group with ABD than in those with HP or MO (P<0.05).
Conclusion. In renal osteodystrophy the OPG/OPGL system is involved in the regulation of bone turnover induced by PTH. The determination of serum OPG levels could be of use in the diagnosis of low turnover bone disease, at least in association with PTH levels 300 pg/ml.
Keywords: bone resorption; bone turnover; osteoprotegerin; PTH; renal osteodystrophy
Notes
Correspondence and offprint requests: Prof. G. Coen, Renal Pathophysiology and Hypertension Unit, Policlinico Umberto I, Viale del Policlinico 155, I-00161 Rome, Italy. Email: coen.gf{at}flashnet.it
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