[Interest of bone alkaline phosphatase in hemodialysis patients]

ABSTRACT

The renal osteodystrophy represent a major complication in haemodialysis. Of this study is to evaluate the value of plasma bone-alkaline phosphatase [bAP] in the diagnosis of the type of renal osteodystrophy among hemodialysis patients and to seek a possible correlation between the bAP, total alkaline phosphatases [tAP] and the intact parathormone [iPTH]. We studied 67 chronic hemodialysis patients. Plasma bAP was determined by immunoenzymatic technic. iPTH [1-84] was measured by electrochimiluminescence. We found that bAP levels were normal 10-20 ng/ml] in 17 patients low [< 10 ng/ml] in 4 and high [> 20 ng/ml] in the 46 other patients. There is a good positive is e correlation between the plasmatic rate of bAP and the following parameters the period of dialysis [R = 0.316, p = 0,009]. plasmatic rate of tAP [r = 0.781. p < 10[-3]] and the rate of iPTH [r = 0,650]. p < 10[-3]]. There is a good positive correlation between the plasmatic rate of bAP and the rates of the tAP and of iPTH, the correlation between bAP and the ipTh being more significant. A rate of bAP higher than 20 ng/ml had a sensitivity of 93,5% specificity of 63,3% in favour of a rate of iPTH > 400 pg/ml and consequently of the biological diagnosis of hyperparathyroidism. In addition, 4 patients have a bAP < 10 ng/ml with iPTH < 150 pg/ml evoking an adynamic osteopathy. plasma bAP provides useful information about bone remodelling in hemodialysis patients