Güneş Gülcan, Doğruer Ünal Nil, Eskandari Gülçin, Kiykim Ahmet, Bölgen Çimen Özlem, Temel Gülhan, Çimen Mehmet Burak Y
Department of Biochemistry, Mersin University Medical Faculty, Mersin, Turkey.
Department of Biochemistry, Mersin University Pharmacy Faculty, Mersin, Turkey.
Int Urol Nephrol. 2018 Jun;50(6):1181-1188. doi: 10.1007/s11255-018-1859-0. Epub 2018 Apr 11.
Chronic kidney disease (CKD) is a progressive condition characterized by irreversible loss of functional nephron mass due to variety of causes; an inevitable complication of CKD is metabolic bone disease, and this pathology is called as renal osteodystrophy (ROD). In this study, we aimed to determine the levels of serum sRANKL and intracellular NF-κB levels in peripheral blood osteoclast precursor cells in patients with stage 3 CKD.
Forty-one male patients aged 35-60 with CKD identified as stage 3 according to GFR calculated on the basis of creatinine values and 27 healthy male subjects with age ranging from 40 to 60 as control group were included in this study. Levels of biochemical parameters, vitamin D3, parathyroid hormone, bone mineral density, sRANKL and NF-κB were determined by using photometric, electrochemiluminescence, HPLC, ELISA and flow cytometric methods in control and patient groups, respectively.
When stage 3 CKD patients were compared with controls, patients with stage 3 CKD had statistically significantly higher iPTH levels, but they had statistically significantly lower vitamin D3 levels. However, the other biochemical parameters, bone mineral density, sRANKL and NF-κB levels did not reveal any significance.
In conclusion, vitamin D3 and iPTH levels seem to be important parameters for evaluating the early stages of ROD. The lack of statistically significant differences in the levels of sRANKL and NF-κB suggests that these parameters are not sufficient in the evaluation of bone metabolism in the early stages of renal failure.
慢性肾脏病(CKD)是一种进行性疾病,其特征是由于多种原因导致功能性肾单位不可逆丧失;CKD的一个不可避免的并发症是代谢性骨病,这种病理状况被称为肾性骨营养不良(ROD)。在本研究中,我们旨在测定3期CKD患者外周血破骨细胞前体细胞中血清sRANKL水平和细胞内NF-κB水平。
本研究纳入了41名年龄在35 - 60岁之间、根据基于肌酐值计算的肾小球滤过率(GFR)被确定为3期CKD的男性患者,以及27名年龄在40 - 60岁之间的健康男性作为对照组。分别采用光度法、电化学发光法、高效液相色谱法、酶联免疫吸附测定法和流式细胞术测定对照组和患者组的生化参数、维生素D3、甲状旁腺激素、骨密度、sRANKL和NF-κB水平。
将3期CKD患者与对照组进行比较时,3期CKD患者的iPTH水平在统计学上显著更高,但维生素D3水平在统计学上显著更低。然而,其他生化参数、骨密度、sRANKL和NF-κB水平未显示出任何显著性差异。
总之,维生素D3和iPTH水平似乎是评估ROD早期阶段的重要参数。sRANKL和NF-κB水平缺乏统计学上的显著差异表明,这些参数在评估肾衰竭早期阶段的骨代谢方面并不充分。