Research Paper Advance Articles
The comparison of serum bone-turnover markers in different stage of chronic kidney disease and the associated impact of intradialytic cycling in patients with end-stage renal disease
- 1 Department of Internal Medicine, Division of Nephrology, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- 2 Department of Internal Medicine, Nephrology division, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
- 3 Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan
- 4 Center of Faculty Development, National Taiwan University College of Medicine, Taipei, Taiwan
- 5 Department of Medical Laboratory, Taoyuan Armed Forces General Hospital, Longtan, Taoyuan 325, Taiwan
- 6 Graduate Institute of Medical Science, National Defense Medical Center, Taipei 114, Taiwan
- 7 Department of Medical Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- 8 Department of Medicine, Division of Radiology, Cardinal-Tien Hospital, New Taipei City 231, Taiwan
- 9 Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
- 10 Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- 11 Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- 12 Department of Medicine, Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
- 13 Department of Medicine, Division of Nephrology, Fu-Jen Catholic University Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 24352, Taiwan
Received: March 29, 2024 Accepted: December 4, 2024 Published: January 14, 2025
https://doi.org/10.18632/aging.206177How to Cite
Copyright: © 2025 Hou et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Bone turnover markers reflected the bone remodeling process and bone health in clinical studies. Studies on variation of bone remodeling markers in different stage CKD were scant, and this study investigated the role of bedside intradialytic cycling in altering concentrations of bone-remodeling markers in patients with end-stage renal disease (ESRD).
Materials and Methods: Participants were segmented into four groups: a group with eGFR >60 ml/min/1.73 m2, a chronic kidney disease group with eGFR 15–60 mL/min/1.73 m2), an ESRD group with an exercise intervention, and an ESRD group with standard care. Comparison of bone turnover markers was performed among groups. The intervention consisting of 12 weeks of intradialytic cycling was performed during dialysis. The variation of bone-remodeling markers was compared between the ESRD with exercise along with the ESRD with standard care after 12-week monitoring.
Results: Bone-formative marker levels (bone-specific alkaline phosphatase and procollagen type 1 amino-terminal propeptide, P1NP) were higher in ESRD patients than in non-ESRD patients and were correlated with indoxyl sulfate and intact parathyroid hormone concentrations (p < 0.05). Postexercise concentrations of tartrate-resistant acid phosphatase-5b (p = 0.003) and N-terminal telopeptide-1 (p = 0.001) had increased in the ESRD patients after 12 weeks of bedside cycling. Bone-formative marker concentration was not altered in the exercise group after cycling.
Conclusion: Bone-formative marker concentrations increased with the severity of chronic kidney disease. Bone formative markers concentration increased along with CKD severity. We demonstrated the bone resorptive markers tartrate-resistant acid phosphatase-5b and N-terminal telopeptide-1 increased after intradialytic cycling in ESRD patients.