Relationship of serum levels of Bone Specific Alkali Phosphatase (bALP) and Alkali Phosphatase (ALP) with vascular calcification in chronic kidney disease patient on chronic hemodialysis

ABSTRACT

Background@#Vascular calcification is an important non-conventional for cardiovascular disease (CVD) in chronic kidney disease (CKD) patients with chronic hemodialysis (HD). Abdominal aortic calcification (AAC) is reported as an independent predictor for cardiovascular morbidity and mortality. Bone-specific Alkali Phosphatase (bALP) and Alkali Phosphatase (ALP) enzymes are produced and released when changes or disorders of bone and mineral metabolism occur. Given biomarker studies such as bALP and ALP which are more often associated with patient mortality, more research will be needed to assess whether these bALP and ALP biomarkers have a linear distribution of relationships with vascular calcification.@*Objective@#This study aimed to evaluate the serum biomarker to predict calcification and further can be one of diagnosis modality of calcification in hemodialysis patients.@*Methods@#A total of 75 chronic HD CKD patients were included in the study. bALP and ALP serum levels were measured with ELISA, as well as AAC measured by lateral abdominal radiographs (X-Ray).@*Results@#bALP and ALP are positively correlated with AAC scores (p value <0.001 and 0.045). Multivariate logistic regression analysis shows that history of diabetes, bALP levels, and parathyroid hormone (PTH) levels are independent risk factors for AAC in chronic HD CKD patients. Receiver Operating Characteristic (ROC) shows the area under the curve (AUC) of bALP and ALP for AAC prediction are 0.882 (95% CI 0.801-0.962; p value <0.001) and 0.634 (95% CI 0.509-0.760; p value 0.045).@*Conclusion@#ALP and especially bALP serum correlate closely with vascular calcification in chronic HD CKD patients accompanied by a superior diagnostic value of bALP biomarkers when compared to ALP.