Serum osteoprotegerin as a marker of renal osteodystrophy in children on hemodialysis

ABSTRACT

Renal Osteodystrophy [ROD] is a common complication in children with chronic renal failure. Osteoprotegerin [OPG] is a newly identified cytokine that plays an important role in bone metabolism. To assess OPG serum levels in children on hemodialysis with ROD and to investigate the correlation between OPG and intact parathyroid hormone [iPTH] serum levels. The present study was carried out on 50 children divided into 2 groups. Group I included 30 children with ROD on regular hemodialysis who were subdivided into 2 subgroups according to iPTH serum values Group IA iPTH levels < 150 pg/ml. Group IB iPTH levels > 300 pg/ml. Group II included 20 apparentely healthy children served as control group with matched age and sex. All patients and controls were subjected to 1- full history taking. 2-Thorough clinical examination. 3-laboratory investigations including serum Ca, P, ALP, iPTH, and OPG. There was a highly significant increase in serum ALP, iPTH and OPG and significant decrease in serum Ca in patients than controls. There was a highly significant increase in serum ALP, iPTH and OPG and highly significant decrease in serum Ca in high iPTH group compared with low iPTH group. Serum Ca was significantly negatively correlated with serum iPTH while ALP and OPG were significantly positively correlated with serum iPTH. No correlation could be detected between serum P level and serum iPTH. Serum OPG combined with iPTH might be a useful marker in the non-invasive diagnosis of ROD in children with chronic renal failure at least in doubtful cases