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Biochemical markers of bone metabolism in CKD 

Biochemical markers of bone metabolism in CKD
Chapter:
Biochemical markers of bone metabolism in CKD
Author(s):

Pablo Ureña

, Klaus Olgaard

, and Kevin Martin

DOI:
10.1093/med/9780199559176.003.011
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date: 25 February 2020

In the absence of bone biopsy, there is no ideal marker of bone remodeling in CKD patients. Recent studies have shown that PTH alone is not necessarily a good biomarker for bone turnover in the setting of CKD, particularly when the levels are modestly increased (3–9 times the upper limit of normal). As such, increased plasma PTH levels are not always synonymous of high turnover bone disease and vice versa. Other bone biomarkers discussed in this chapter provide useful information at the extremes but each one alone is not more valuable that PTH, particularly at distinguishing low from normal bone turnover. The combined use of PTH with some of the more accessible biomarkers of bone remodeling have the potential to improve the diagnosis, monitoring, and treatment monitoring of CKD-MBD in the future. However, further studies are clearly required to examine the utility of these biomarkers and their correlations with bone histology in the current era.

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