Utility of serum tartrate-resistant acid phosphatase (TRACP5b) as a bone resorption marker in patients with chronic kidney disease: independence from renal dysfunction.

ABSTRACT

BACKGROUND: Serum tartrate-resistant acid phosphatase (TRACP) 5b levels were assessed in predialysis patients with chronic kidney disease (CKD). The aim of the study was to establish the usefulness of a new assay for TRACP5b in assessing bone turnover in these patients. METHODS: Serum concentrations of two bone resorption markers, TRACP5b and N-terminal cross-linking telopeptide of type I collagen (NTX); two bone formation markers, bone specific alkaline phosphatase (bone ALP) and intact osteocalcin (OC[1-49]); and PTH were measured in 98 predialysis CKD patients. RESULTS: Log serum TRACP5b and other bone markers were significantly negatively correlated with glomerular filtration rate (GFR) and positively correlated with log serum PTH, suggesting an increase in serum bone markers with development of secondary hyperparathyroidism. Multiple regression analysis including age, gender, BMI, the presence of diabetes, GFR and log serum PTH showed an association of log serum PTH with log serum TRACP5b and other bone markers. GFR was associated with log serum NTX and log OC[1-49], but not with log serum TRACP5b or log bone ALP. These data show that renal dysfunction does not influence serum TRACP5b and bone ALP, but has an influence on NTX and OC[1-49]. CONCLUSION: Serum TRACP5b may be a good marker for serum bone resorption in predialysis CKD patients, as it is not affected by renal dysfunction.