{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T17:31:04Z","timestamp":1776360664258,"version":"3.51.2"},"reference-count":42,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004809","name":"FINEP","doi-asserted-by":"publisher","award":["01.16.0079.00"],"award-info":[{"award-number":["01.16.0079.00"]}],"id":[{"id":"10.13039\/501100004809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004809","name":"FINEP","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100004809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","award":["01.16.0079.00"],"award-info":[{"award-number":["01.16.0079.00"]}]},{"name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","award":["001"],"award-info":[{"award-number":["001"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro (FAPERJ\u2014CNE Maurilo Leite Jr)","award":["01.16.0079.00"],"award-info":[{"award-number":["01.16.0079.00"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro (FAPERJ\u2014CNE Maurilo Leite Jr)","award":["001"],"award-info":[{"award-number":["001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Renal osteodystrophy (ROD) represents histological bone changes in patients with chronic kidney disease and is classified according to turnover and mineralization. This cross-sectional study evaluates several bone biomarkers and their ability to discriminate turnover and mineralization defects in hemodialysis (HD) patients. Bone-specific [BSAP] and total [tAP] alkaline phosphatase, procollagen-1 N-terminal propeptide [P1NP], C-terminal cross-linking telopeptide [CTX], intact [iPTH] and whole [wPTH] parathyroid hormone, sclerostin [SOST], fibroblast growth factor 23 [FGF-23], vitamin D, osteoprotegerin [OPG], and receptor activator of nuclear factor \u03baB ligand [RANKL] were collected before the bone biopsy. Thirty-two patients were evaluated by bone histomorphometry, which identified mineralization defects and low and high turnover in 47%, 50%, and 41% of patients, respectively. Bone biomarkers (tAP, BSAP, CTX, P1NP) and hormones (iPTH, wPTH, and SOST) were capable of identifying low and high turnover (AUC &gt; 0.877 and &gt;0.857, respectively, p &lt; 0.001). PTH plus AP had the best accuracy for identifying high turnover. BSAP &gt; 2x, iPTH &gt; 8x, and wPTH &gt; 6x upper limit of normal range identified high turnover. Lower calcium values (Ca &lt; 8.7 mg\/dL) were correlated with mineralization defects. On the other hand, FGF-23, OPG, and RANKL did not impact the turnover and mineralization. While bone histomorphometry is not widely available, bone biomarkers such as BSAP, P1NP, PTH, and calcium allow the assessment of turnover and mineralization defects in HD patients. Then, using bone biomarkers may help clinicians define treatments for ROD and osteoporosis and monitor therapeutic response.<\/jats:p>","DOI":"10.3390\/life14121540","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T05:21:32Z","timestamp":1732512092000},"page":"1540","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Bone Biomarkers in Renal Osteodystrophy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-9796","authenticated-orcid":false,"given":"Alinie","family":"Pichone","sequence":"first","affiliation":[{"name":"Division of Nephrology, Hospital Universit\u00e1rio Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universit\u00e1ria, Rio de Janeiro 21941-617, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4565-7404","authenticated-orcid":false,"given":"Carlos Perez","family":"Gomes","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hospital Universit\u00e1rio Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universit\u00e1ria, Rio de Janeiro 21941-617, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Aguiar","family":"Moreira","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Academic Research Center of Pro Renal Institute, Rua Vicente Machado, 2190, Curitiba 80060-900, PR, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Lucia Fleiuss","family":"Farias","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Hospital Universit\u00e1rio Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universit\u00e1ria, Rio de Janeiro 21941-617, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2030-598X","authenticated-orcid":false,"suffix":"Jr.","given":"Maurilo","family":"Leite","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hospital Universit\u00e1rio Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255-Cidade Universit\u00e1ria, Rio de Janeiro 21941-617, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1016\/j.kint.2021.07.029","article-title":"The state of the global nephrology workforce: A joint ASN-ERA-EDTA-ISN investigation","volume":"100","author":"Sozio","year":"2021","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1038\/ki.2012.176","article-title":"Update on fibroblast growth factor 23 in chronic kidney disease","volume":"82","author":"Wolf","year":"2012","journal-title":"Kidney Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.kint.2015.12.004","article-title":"Changing bone patterns with progression of chronic kidney disease","volume":"89","author":"Massy","year":"2016","journal-title":"Kidney Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.kint.2016.12.029","article-title":"The complexity of chronic kidney disease-mineral and bone disorder across stages of chronic kidney disease","volume":"91","author":"Graciolli","year":"2017","journal-title":"Kidney Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1038\/sj.ki.5000414","article-title":"Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"69","author":"Moe","year":"2006","journal-title":"Kidney Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S151","DOI":"10.2215\/CJN.04301206","article-title":"Histomorphometric measurements of bone turnover, mineralization, and volume","volume":"3","author":"Ott","year":"2008","journal-title":"Clin. 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