study of possible correlation between inflammation and bone mineral disorders in chronic kidney disease

Research Article
Said S.Khamis,Hany S. Elbarbary,Mahmoud M. Emara , Enas S. Essa and Ahmed A.Zayed
hs CRP; alkaline phosphatase; PTH; CKD-MBD.

Objectives: This study was done to evaluate possible correlation between inflammation detected by the inflammatory marker; high sensitivity C-reactive protein (hs –CRP) and bone mineral disorders in chronic kidney disease patients detected by laboratory and radiological investigations.

Background: Changes in mineral metabolism and bone structure develop early in the course of chronic kidney disease (CKD) and worsen with progressive loss of kidney function. The magnitude of these changes may also be influenced by various therapeutic interventions, such as vitamin D administration and may contribute to such outcomes as fractures, skeletal deformities, and poor growth which persist despite normalization of bone turnover. Chronic inflammatory state in CKD patients due to many underlying factors, including the uremic milieu, elevated levels of circulating proinflammatory cytokines, oxidative stress, carbonyl stress, protein-energy wasting might have possible correlation with bone mineral disorders in chronic kidney disease

Methods: Plasma samples were obtained from CKD patients who were classified into 4 groups 20 patients as control group (stage I,II)and 30 patients ( CKD stage III,IV,V)10 patients in each group .The level of hs CRP, alkaline phosphatase, calcium, phosphorus and PTH level were determined in each patient to see if there is possible correlation between high sensitivity C-reactive protein as an inflammatory marker and bone mineral disorders in chronic kidney disease patients

Results: Patients were categorized into groups depending on their estimated GFR by modified diet for renal disease (MDRD) method; there were no significant differences in age, gender and smoking between the four groups. There was positive significant correlation between hs CRP level and alkaline phosphatase, phosphorus level and parathyroid hormone (PTH). However there was no significant correlation with calcium level.

Conclusion: from this study we concluded that there is a possible correlation between hs CPR as an inflammatory biomarker with laboratory and radiological findings in CKD-mineral bone disorders (MBD)