CKD_MBD types and inflammation are considered risk factors for all cause mortality in hemodialysis setting . Biomarkers of CKD- MBD (Osteoprogerin ,Crosslaps ,Rankl) correlate with bone disease types in different ways. RANKL is essential in function of osteoclasts, is involved in cancer, stimulates RANK+ M2 macrophages.To establish the relationship of CKD-MBD biomarkers with inflammatory biomarkers and their role of independent predictor for all cause mortality .
Prospective longitudinal study , a cohort of prevalent hemodialysis patients (n32) is followed for a twelve months period . The main characteristics were recorded at baseline. At baseline : bone biomarkers(BB) : osteoprotegerin (OPG), CrossLaps, Rankl ,OPG/RANKL and OPG*Crosslaps/Rankl ; inflammatory(BI): baseline CPR, CPR after two months (PCR1), Serum amyloid protein. The bone turnover is classified according to PTH plus alkaline phosphatase. The relationship between types of bone turnover and (BB) is detected by the analysis of variance (ANOVA) ; The association between type of bone turnover and PTH is tested by general mixed model analysis. The relationship between (BB) and (BI) was determined by linear regression of correlation analysis . Survival analysis is conducted using adjusted Cox regression and Kaplan – meier curve .
The types of bone disease correlate significantly with the values of crosslaps (P trend 0.01 ). The Pth values are correlated directly with crosslaps and OPG* CrossLaps / RANKL indirectly. The integrated measurement OPG* crosslaps / RANKL mRNA correlates significantly with PCR 1(P 0,001) and serum amyloid protein (P 0,00000) independently . Mortality from all causes was independently related to low-turnover bone disease ;there was a significant trend for OPG (0.09) and OPG / RANKL (P 0.17), despite the small sample.
There is a correlation between bone and inflammatory biomarkers that can intervene in the relation between adynamic osteopathy and mortality
