The Relationship Between Osteopontin Levels, Parathyroid Hormone, and Alkaline Phosphatase in Chronic Kidney Disease Patients: A Marker for Mineral and Bone Diseases

Abstract

Background: The 5th stage of renal failure is known as ESRD, which requires dialysis or transplantation of the kidneys. CKD leads to metabolism impairment of P, Ca2+, PTH, and vitamin D. CKD-MBD is described as CKD that has resulted biochemical laboratory irregularities, severe disease of the bones, and/or calcification of the vascular system. OPN is a calcium-binding glycolphosphoprotein
discovered in bones. OPN is associated with eGFR, iPTH, AP, and ionized calcium. Aim: To assess the OPN levels in CKD stages (3, 4, and 5) ND and stage 5 on (HD), as well as their relationship with PTH and AP, and to determine if OPN may be used as a marker for CKD/MBD. Material and methods: The cross-sectional investigation comprised 80 patients with CKD at nephrology and hemodialysis units at Tanta University Hospitals (six months). They were separated into two groups. 1) 40 individuals with CKD stage 5-HD. 2) 40 patients with CKD stages 3, 4, and 5- ND. All participants underwent a complete history, clinical examination, and laboratory investigations, including kidney function tests (urea, creatinine, GFR, eGFR, serum ionized calcium level, serum phosphorus level, serum alkaline phosphatase, serum iPTH level, serum osteopontin level), and radiological investigations (abdominal ultrasound). Results: In terms of calcium supplementation and vitamin D, the hemodialysis group performed significantly better than the CKD
group. The hemodialysis group had substantially greater levels of osteopontin and PTH compared to the CKD group (p ˂ 0.001). While alkaline phosphatase levels were considerably lower in the hemodialysis group. In both groups, osteopontin was positively linked with alkaline phosphatase (p=0.003) and PTH (p <0.001). Osteopontin had good sensitivity and specificity in predicting CKDMBD in the hemodialysis group (99.9%, 99.9%) and (p <0.001), and acceptable in the CKD group (90.9%, 87%) (p < 0.001). Conclusion: OPN correlated significantly with CK-DMBD markers. OPNO levels are a useful indicator for predicting mineral bone damage in CKD patients.