{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:21:19Z","timestamp":1770816079359,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,6,27]],"date-time":"2016-06-27T00:00:00Z","timestamp":1466985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction:<\/jats:bold>Noninvasive measures of bone activity include intact parathyroid hormone (iPTH) and bone\u2010specific alkaline phosphatase (BSAP). Whether BSAP measurement alone or in combination with other biochemical data provides more reliable information about bone turnover than iPTH alone in African Americans on hemodialysis is unknown.<jats:bold>Methods:<\/jats:bold>This cross\u2010sectional study aimed to determine the optimal predictor and cutoff points for BSAP, iPTH, calcium and phosphorus in classifying bone biopsy findings. Forty\u2010three African American hemodialysis patients were available for analysis. Biochemical data on the day of biopsy across a spectrum of qualitative histologic bone features were compared. Classification and regression tree analysis was used to determine both the optimal predictor and cutoff points for BSAP, iPTH, calcium and phosphorus in identifying bone turnover status.<jats:bold>Findings:<\/jats:bold>Seven subjects had adynamic disease, 31 had mild\/moderate hyperparathyroid bone features, and five had severe hyperparathyroid bone disease. BSAP was the optimal predictor of bone biopsy with a cutoff point of 22 ng\/mL. Calcium and phosphorus had no predictive value. At BSAP\u2009\u2264\u200922 ng\/mL, subjects had either adynamic bone disease or mild\/moderate hyperparathyroid bone disease but iPTH was not useful in further classifying biopsy findings. When BSAP was &gt;22 ng\/mL, subjects had either mild\/moderate or severe hyperparathyroid bone disease, and iPTH was useful in further classifying biopsy findings. With BSAP\u2009&gt;\u200922 ng\/mL and iPTH\u2009&lt;\u2009726 pg\/mL, all subjects had mild\/moderate bone turnover features.<jats:bold>Discussion:<\/jats:bold>Compared to iPTH, BSAP was shown to be the optimal predictor of biopsy findings with an optimal cutoff at 22 ng\/mL.<\/jats:p>","DOI":"10.1111\/hdi.12454","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T02:18:50Z","timestamp":1467166730000},"page":"90-96","source":"Crossref","is-referenced-by-count":10,"title":["Bone\u2010specific alkaline phosphatase and bone turnover in African American hemodialysis patients"],"prefix":"10.1111","volume":"21","author":[{"given":"Lenar","family":"Yessayan","sequence":"first","affiliation":[{"name":"Division of Nephrology University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Medicine University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Moore","sequence":"additional","affiliation":[{"name":"Division of Nephrology Henry Ford Hospital Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Hospital Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry","family":"Yee","sequence":"additional","affiliation":[{"name":"Division of Nephrology Henry Ford Hospital Detroit Michigan USA"},{"name":"Department of Internal Medicine Henry Ford Hospital Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000414"},{"key":"e_1_2_6_3_1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease\u2010mineral and bone disorder (CKD\u2010MBD)","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD\u2010MBD Work Group","year":"2009","journal-title":"Kidney Int Suppl"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.77"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09580911"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V73506"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.309"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01870408"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2000.19812"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn466"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00129.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01770408"},{"key":"e_1_2_6_13_1","doi-asserted-by":"crossref","unstructured":"MallucheHH FaugereM\u2010C.Atlas of mineralized bone histology 1986.","DOI":"10.1159\/isbn.978-3-318-04339-6"},{"key":"e_1_2_6_14_1","volume-title":"Classification and Regression Trees","author":"Breiman L","year":"1984"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9861(88)90305-0"},{"key":"e_1_2_6_16_1","first-page":"3","article-title":"Glycosyl\u2010phosphatidylinositol anchored membrane enzymes","volume":"266","author":"Hooper NM.","year":"1997","journal-title":"Int J Clin Chem"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002239900441"},{"key":"e_1_2_6_18_1","first-page":"137","article-title":"Quantitation of soluble and skeletal alkaline phosphatase, and insoluble alkaline phosphatase anchor\u2010hydrolase activities in human serum","volume":"311","author":"Anh DJ","year":"2001","journal-title":"Int J Clin Chem"},{"key":"e_1_2_6_19_1","first-page":"125","article-title":"Elimination of alkaline phosphatases from circulation by the galactose receptor. 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