Kagebayashi Y, Samma S, Yoshida K, Ozono S, Motomiya Y, Hirao Y, Fujii Y, Kishimoto T, Dohi K, Okajima E
Department of Urology, Nara Medical University, Japan.
Nihon Jinzo Gakkai Shi. 1996 Jun;38(6):248-53.
The concentrations of pyridinoline (Pyr), a novel marker of bone resorption, were simultaneously measured in both serum and urine samples by ion-paired high-performance liquid chromatography in 27 patients with predialysis chronic renal failure. The patients consisted of 19 males and 8 females, whose creatinine clearance (Ccr) ranged from 2.5 to 47.6 ml/min. The influence of residual renal function on serum Pyr and the clinical significance of serum and urinary Pyr were analyzed in patients with predialysis chronic renal failure. There were significant correlations between serum Pyr and serum Cr (r = 0.76) and between Pyr clearance and Ccr (r = 0.70). In addition, significant correlations were observed serum and urinary Pyr (r = 0.64) and between both serum and urinary Pyr and HS-PTH (r = 0.96 and r = 0.61, respectively) and osteocalcin (r = 0.80 and r = 0.73, respectively). However, serum bone alkaline phosphatase isoenzyme (ALP3) was correlated with neither serum nor urinary Pyr. There was no correlation between the ratio of serum Pyr/serum Cr and the metabolic bone markers (HS-PTH, osteocalcin and ALP3). There was a correlation between Ccr and urinary Pyr, although it was statistically significant (p < 0.1). These date led to the following conclusions: (1) serum Pyr in patients with oredialysis chronic renal failure is influenced by reduced renal function and (2) urinary pyr shows a state of bone resorption when an adegvafe level of renal function is maintained. This suggests that patients with an advanced stage of renal osteodystrophy are included among cases of predialysis chronic renal failure.
采用离子对高效液相色谱法，同时检测了27例透析前慢性肾衰竭患者血清和尿液样本中骨吸收新标志物吡啶啉（Pyr）的浓度。患者包括19名男性和8名女性，其肌酐清除率（Ccr）范围为2.5至47.6 ml/min。分析了残余肾功能对透析前慢性肾衰竭患者血清Pyr的影响以及血清和尿液Pyr的临床意义。血清Pyr与血清肌酐（r = 0.76）以及Pyr清除率与Ccr（r = 0.70）之间存在显著相关性。此外，血清和尿液Pyr之间（r = 0.64）以及血清和尿液Pyr与全段甲状旁腺激素（HS-PTH）（分别为r = 0.96和r = 0.61）和骨钙素（分别为r = 0.80和r = 0.73）之间均观察到显著相关性。然而，血清骨碱性磷酸酶同工酶（ALP3）与血清或尿液Pyr均无相关性。血清Pyr/血清肌酐比值与代谢性骨标志物（HS-PTH、骨钙素和ALP3）之间无相关性。Ccr与尿液Pyr之间存在相关性，尽管无统计学意义（p < 0.1）。这些数据得出以下结论：（1）透析前慢性肾衰竭患者的血清Pyr受肾功能降低的影响；（2）当维持足够的肾功能水平时，尿液Pyr显示骨吸收状态。这表明肾性骨营养不良晚期患者包括在透析前慢性肾衰竭病例中。
