Serum crosslinked N-terminal telopeptide of type 1 collagen for evaluation of bone loss in hemodialysis patients using dual-energy X-ray absorptiometry

Abstract

BACKGROUND: Useful markers of bone resorption are needed for hemodialysis (HD) patients with renal osteodystrophy. The present study investigated the use of a new immunoassay for the crosslinked N-terminal telopeptide of type 1 collagen to assess bone loss in HD patients. METHODS: Forty-seven male and 19 female patients were enrolled in this study. Their mean age was 64 years, and the mean duration they had been receiving HD was 110 months at the time of investigation. Their mean body mass index (BMI) was 21 kg/m2. Serum levels of N-terminal telopeptide of type 1 collagen (NTx) and of total calcium (Ca), phosphorus (P), alkaline phosphatase (Alp), and intact parathyroid hormone (PTH) were measured. Bone mineral density (BMD) of the distal one-third of the radius was examined by dual-energy x-ray absorptiometry. RESULTS: Serum levels of NTx, Ca, P, Alp, and intact PTH were 68.9 nmol BCE/L, 4.5 mEq/L, 6.3 mg/dL, 248 IU/L, and 241 pg/mL, respectively. BMD was positively correlated with BMI (r = 0.24, p < .05) and negatively correlated with NTx (r = -0.27, p < .05) and duration of HD (r = -0.24, p < .05). CONCLUSIONS: Serum NTx could be a useful marker of bone resorption in patients with renal osteodystrophy. If high serum NTx is found, then treatment for prevention of bone loss should be considered.