Journal Article

Serum osteoprotegerin and renal osteodystrophy

Giorgio Coen, Paola Ballanti, Alessandro Balducci, Santo Calabria, Maria Stephanie Fischer, Ljiljana Jankovic, Micaela Manni, Massimo Morosetti, Eleonora Moscaritolo, Daniela Sardella and Ermanno Bonucci

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 17, issue 2, pages 233-238
Published in print February 2002 | ISSN: 0931-0509
Published online February 2002 | e-ISSN: 1460-2385 | DOI:
Serum osteoprotegerin and renal osteodystrophy

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Background. Numerous growth factors and cytokines are known to modulate bone turnover. An important, recently discovered complex involved in osteoclastogenesis is the osteoprotegerin/osteoprotegerin‐ligand (OPG/OPGL) cytokine complex, which is produced by osteoblasts. Many factors, including parathyroid hormone (PTH), appear to affect bone turnover through this pathway. In this disorder, the role of the OPG/OPGL system in the pathogenesis of renal osteodystrophy, a disease with either low or high bone turnover, has not been investigated so far.

Methods. Thirty‐nine chronic haemodialysis patients had bone biopsies, including histomorphometric and histodynamic examinations. In addition, the following serum biochemistry parameters were measured: serum OPG, intact PTH, PTH 1–84, total PTH, osteocalcin, total and bone alkaline phosphatases, 25‐hydroxycholecalciferol and 1,25‐dihydroxycholecalciferol.

Results. On average, serum OPG levels were above the normal range. They were lower in adynamic bone disease (ABD) patients, than in patients with predominant hyperparathyroidism (HP) or mixed osteodystrophy (MO). Significant negative correlations were found between serum OPG and PTH levels, and between serum OPG and parameters of bone resorption (ES/BS) and bone formation (ObS/BS and BFR/BS) in HP and MO patients with PTH values ≤1000 pg/ml. For intact PTH levels ≤300 pg/ml, serum OPG was significantly lower in the group with ABD than in those with HP or MO (P<0.05).

Conclusion. In renal osteodystrophy the OPG/OPGL system is involved in the regulation of bone turnover induced by PTH. The determination of serum OPG levels could be of use in the diagnosis of low turnover bone disease, at least in association with PTH levels ≤300 pg/ml.

Keywords: bone resorption; bone turnover; osteoprotegerin; PTH; renal osteodystrophy

Journal Article.  3310 words.  Illustrated.

Subjects: Nephrology

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