Use of Alkaline Phosphatase as a Bone Marker in Patients on Hemodialysis
Bibliographic record
Abstract
Background: Some patients on hemodialysis may suffer from high turnover bone disease despite having levels of parathormone (PTH) within the targets set by KDIGO. Recent international guidelines suggest the use of other bone markers, such as serum total and bone-specific alkaline phosphatase (TALP and BALP respectively). The caveat of using TALP to assess bone turnover status is that other conditions, such as hepatic cholestasis, also cause increases in TALP. We can, however, use it as an alternative to BALP as long as gamma-glutamyl-transferase (GGT) is normal. Though it would generally be expected that PTH and TALP move in the same direction with changes in bone turnover, these two markers can sometimes evolve in opposite directions. Our study aimed to evaluate the correlation between PTH, TALP and BALP. Methods: Cross sectional study including all patients on hemodialysis at the Hôpital Maisonneuve-Rosemont from May 9, 2019 to June 7, 2019 (N=264 patients). We measured PTH, TALP and BALP in these patients and correlation coefficients were calculated. Regression analyses were performed for multiple potential confounding factors. Results: The correlation between PTH and TALP was found to be positive and moderate (Rho 0.36; p-value < 0.0001). It was not statistically significant in patients having high GGT levels (above 60 IU/L) and was stronger in patients with normal GGT (Rho 0.40; p-value < 0.0001). The correlation between PTH and BALP was also positive and moderate, but stronger than with TALP (Rho 0.43; p-value <0.0001) and statistically significant even in patients having high GGT levels. The correlation between TALP and BALP was positive, strong and statistically significant (Rho 0.86 ; p-value <0.0001) ; it was stronger when GGT levels were normal compared to patients with high GGT levels (Rho 0.94 and Rho 0.71 respectively). Conclusions: There is a positive correlation between PTH and TALP but it is only moderate. It is thus important to take into consideration TALP in patients with normal GGT levels when evaluating the bone status of patients on hemodialysis.Correlation coefficients for all patients and stratified by GGT level
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".