Osteocalcin serum levels in patients following renal transplantation

Publisher Website
Google Scholar
Abstract
Osteocalcin serum levels reflect bone turnover. In renal insufficiency secondary hyperparathyroidism and reduced renal clearance might be responsible for elevated serum levels of osteocalcin. Renal transplantation might improve renal osteodystrophy and therefore could influence osteocalcin serum levels. We determined the influence of renal transplantation on osteocalcin levels in 37 consecutive patients (25m/12f) by RIA. Blood samples were collected prior to, 3 days, 28 days, 6 months and 12 months after renal transplantation. Prior to renal transplantation osteocalcin levels were significantly elevated (x±s: 23.4±12.8 ng/ml) compared to healthy volunteers (4.1±1.4 ng/ml). Following renal transplantation osteocalcin decreased significantly (9.4±8.9 ng/ml) 3 days and (7.1±7.8 ng/ml) 28 days. However, 6 and 12 months following renal transplantation the mean osteocalcin level increased again (8.3±5.7 ng/ml, 12.1±15.4 ng/ml). At 6 months 11 and at 12 months only 6 of 37 patients had osteocalcin levels in the normal range. 12 months following renal transplantation 21 out of 37 patients with elevated osteocalcin levels had parathyroid hormone levels above the normal range. Additionally to increased osteocalcin levels patients prior to renal transplantation had elevated alkaline phosphatase. Alkaline phosphatase had following renal transplantation a similar pattern as osteocalcin with initial decrease and secondary increase 6 and 12 months after renal transplantation. Parathyroid hormone was elevated in all patients before renal transplantation. Following renal transplantation mean parathyroid hormone levels fell significantly, however remained above normal range in 57% of these 37 patients. Osteocalcin serum levels correlated positively with alkaline phosphatase (rs=0.43−0.62;pp<0.07). This correlation of osteocalcin with alkaline phosphatase and parathyroid hormone prior to and after renal transplantation suggests that osteocalcin may be a confirmative parameter in renal osteodystrophy in patients on chronic intermittent hemodialysis and following renal transplantation.