Effect of hemodiafiltration on sclerostin level and bone specific alkaline phosphatase in comparison with high flux dialysis

Abstract

Background: sclerostin, an osteocyte‐derived glycoprotein acts as a soluble inhibitor of the Wnt signaling pathway and its physiological role is to reduce bone formation. The serum scler‐ostin levels increase with the progression of CKD. Aim of the work: in the present study, we investigated the effect of three months thrice weekly hemodiafiltration on serum sclerostin level and bone specific alkaline phosphatase in comparison with high flux dialysis in stable HD patients. Methods: prospective study was concluded upon 32 randomly selected ESRD patients from Dialysis Department in Ain Shams University Hospitals and Maadi Military Hospital. Serum sclerostin and bone specific alkaline phosphatase were measured at the start of the study (Zero months) and after 3 months of HDF dialysis between September 2017 and December 2017. Results: 32 test subjects were randomly selected had mean age 47.38 (± 18.68 years) in HDF group and 55.31 (± 7.40 years) in high flux group. 56.3 % were male in HDF group, 81.3 % male in high flux group. Patients in HDF group had serum sclerostin reduction ratio with mean 24.72 ± 10.34 pre‐3 months and mean 30.34 ± 12.22 in post‐3 months. While, serum sclerostin reduction ratio mean was 18.97 ± 7.87 in high flux group. There was a statistically significant difference between HDF group post‐3 months and high flux group as regard sclerostin reduction ratio (P‐value: 0.015). There was no statistically significant difference between group HDF post‐3 months and group high flux as regard BS‐AP reduction ratio (P‐value: 0.212). Conclusion: Sclerostin decreased by HDF. Yet, HDF has no effect on bone specific alkaline phosphatase in comparison to high flux hemodialysis.