Tóm tắt
ABSTRACT
Objective: (1) To evaluate the mineral and bone disorders, bone mineral density, and serum sclerostin levels in patients with chronic kidney disease undergoing maintenance hemodialysis, compared with a healthy control group with normal renal function. (2) To evaluate the relationship between serum sclerostin concentration and CKD – Mineral and Bone disorders (CKD-MBD) in hemodialysis patients.
Patients and methods: This is a cross-sectional descriptive study on 51 CKD hemodialysis patients at the Department of Nephrology - Musculoskeletal, Hue Central Hospital and 60 healthy people with normal kidney function regularly came for health check-ups at the Internal Medicine Clinic of Hue University of Medicine and Pharmacy from April 2023 to 2025.
Results: The study population in our research consisted of two groups: a control group comprising 60 individuals, including 25 males and 35 females, with a mean age of 49.27 ± 10.98; and a G5HD group including 31 males and 20 females, with a mean age of 47.92 ± 14.88. The difference in age between the two groups was not statistically significant (p>0.05). The mean serum calcium (adjusted for serum albumin), phosphorus, and PTH concentrations in 52 patients undergoing hemodialysis in the study were 2,330 ± 0.218 mmol/l; 2,034 ± 0.588 mmol/l, and 711,318 ± 905,620 pg/dL, respectively. In terms of blood calcium disorders, 11.76% of patients had hypocalcemia and about 1/5 had hypercalcemia. Our study found that 86.27% had hyperphosphatemia and more than 90% of G5HD patients had increased serum PTH levels. Regarding bone density in the G5HD group, the mean BMD at the femoral neck, total femur, and lumbar spine were 0.820 ± 0.221; 0.840 ± 0.194 and 1.003 ± 0.194 g/cm2, respectively. The mean serum sclerostin concentration in the control group of our study was 359.52 ± 168.21 pg/mL. The G5HD groups exhibited significantly higher serum sclerostin level compared to the control group (p < 0.05); the mean concentrations was 937.152 ± 881.105 pg/ml. Serum sclerostin concentrations in hemodialysis patients were significantly negatively correlated with serum PTH and bone mineral density at the femoral neck and total hip (p<0.05).
Conclusion: In conclusion, according to our study, CKD-MBD are common in patients with end-stage renal disease undergoing maintenance hemodialysis. Serum sclerostin levels were significantly higher in the hemodialysis group compared to healthy controls. Regarding the association between sclerostin and mineral-bone disorders as well as bone mineral density in hemodialysis patients, our findings demonstrate that serum sclerostin levels were significantly and inversely correlated with PTH levels and bone mineral density at the femoral neck and total hip.
| Đã xuất bản | 30-04-2026 | |
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| Số tạp chí | Tập 16 Số 02 (2026) | |
| Phân mục | Nghiên cứu | |
| DOI | 10.34071/jmp.2026.2.742 | |
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công trình này được cấp phép theo Creative Commons Attribution-phi thương mại-NoDerivatives 4.0 License International .
Bản quyền (c) 2026 Tạp chí Y Dược Huế
KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney international supplements. 2017;7(1):1-59.
ten Dijke P, Krause C, de Gorter DJ, Löwik CW, van Bezooijen RL. Osteocyte-derived sclerostin inhibits bone formation: its role in bone morphogenetic protein and Wnt signaling. The Journal of bone and joint surgery American volume. 2008;90 Suppl 1:31-5.
Abdallah E, Sherif N, Mosbah O, Metwally A, Abd ElAzim I, Mahmoud O, et al. The Relationship between Serum Sclerostin Levels and Bone Mineral Disorders and Vascular Calcification in Hemodialysis Patients. Open Access Macedonian Journal of Medical Sciences. 2021;9(B):1664-71.
Delanaye P, Krzesinski JM, Warling X, Moonen M, Smelten N, Médart L, et al. Clinical and biological determinants of sclerostin plasma concentration in hemodialysis patients. Nephron Clinical practice. 2014;128(1-2):127-34.
Lu JW, Syu RJ, Wang CH, Hsu BG, Tsai JP. Serum Sclerostin Level Is Negatively Associated with Bone Mineral Density in Hemodialysis Patients. Medicina (Kaunas, Lithuania). 2022;58(3).
Nakagawa Y, Komaba H, Wada T, Takahashi H, Takahashi Y, Hyodo T, et al. Serum Sclerostin Levels and Mortality in Hemodialysis Patients: An 8-Year Prospective Study. American journal of nephrology. 2022;53(11-12):767-74.
Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Annals of internal medicine. 2013;158(11):825-30.
Nguyễn Hữu Vũ Quang. Nghiên cứu nồng độ FGF-23 huyết thanh và mối liên quan với một số rối loạn khoáng xương ở bệnh nhân bệnh thận mạn [Luận án tiến sĩ y học]: Đại học Y-Dược, Đại học Huế; 2020.
Slouma M, Sahli H, Bahlous A, Laadhar L, Smaoui W, Rekik S, et al. Mineral bone disorder and osteoporosis in hemodialysis patients. Advances in rheumatology (London, England). 2020;60(1):15.
Cejka D, Jäger-Lansky A, Kieweg H, Weber M, Bieglmayer C, Haider DG, et al. Sclerostin serum levels correlate positively with bone mineral density and microarchitecture in haemodialysis patients. Nephrology Dialysis Transplantation. 2011;27(1):226-30.
Viaene L, Behets GJ, Claes K, Meijers B, Blocki F, Brandenburg V, et al. Sclerostin: another bone-related protein related to all-cause mortality in haemodialysis? Nephrology Dialysis Transplantation. 2013;28(12):3024-30.
Ishimura E, Okuno S, Ichii M, Norimine K, Yamakawa T, Shoji S, et al. Relationship Between Serum Sclerostin, Bone Metabolism Markers, and Bone Mineral Density in Maintenance Hemodialysis Patients. The Journal of Clinical Endocrinology & Metabolism. 2014;99(11):4315-20.
Keller H, Kneissel M. SOST is a target gene for PTH in bone. Bone. 2005;37(2):148-58.
Asamiya Y, Yajima A, Shimizu S, Otsubo S, Tsuchiya K, Nitta K. Associations between the levels of sclerostin, phosphate, and fibroblast growth factor-23 and treatment with vitamin D in hemodialysis patients with low intact PTH level. Osteoporosis International. 2014;26.
Elsalam MA, El-Abden MZ, Mahmoud E, Zahab ZA, Ahmed H. Correlation between serum sclerostin level and bone density status in children on regular hemodialysis. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2019;30(5):1022-31.
Bellido T, Ali AA, Gubrij I, Plotkin LI, Fu Q, O’Brien CA, et al. Chronic elevation of parathyroid hormone in mice reduces expression of sclerostin by osteocytes: a novel mechanism for hormonal control of osteoblastogenesis. Endocrinology. 2005;146(11):4577-83.