Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Jan 14;17(1):217-231.
doi: 10.18632/aging.206177. Epub 2025 Jan 14.

The comparison of serum bone-turnover markers in different stage of chronic kidney disease and the associated impact of intradialytic cycling in patients with end-stage renal disease

Yi-Chou Hou  1 , Chia-Ter Chao  2   3   4 , Li-Jane Shih  5   6 , Kuo-Wang Tsai  7 , Shyh-Min Lin  8 , Ruei-Ming Chen  9   10   11 , Kuo-Cheng Lu  12   13
Affiliations
Comparative Study

The comparison of serum bone-turnover markers in different stage of chronic kidney disease and the associated impact of intradialytic cycling in patients with end-stage renal disease

Yi-Chou Hou et al. Aging (Albany NY). .

Abstract

Introduction: Bone turnover markers reflected the bone remodeling process and bone health in clinical studies. Studies on variation of bone remodeling markers in different stage CKD were scant, and this study investigated the role of bedside intradialytic cycling in altering concentrations of bone-remodeling markers in patients with end-stage renal disease (ESRD).

Materials and methods: Participants were segmented into four groups: a group with eGFR >60 ml/min/1.73 m2, a chronic kidney disease group with eGFR 15-60 mL/min/1.73 m2), an ESRD group with an exercise intervention, and an ESRD group with standard care. Comparison of bone turnover markers was performed among groups. The intervention consisting of 12 weeks of intradialytic cycling was performed during dialysis. The variation of bone-remodeling markers was compared between the ESRD with exercise along with the ESRD with standard care after 12-week monitoring.

Results: Bone-formative marker levels (bone-specific alkaline phosphatase and procollagen type 1 amino-terminal propeptide, P1NP) were higher in ESRD patients than in non-ESRD patients and were correlated with indoxyl sulfate and intact parathyroid hormone concentrations (p < 0.05). Postexercise concentrations of tartrate-resistant acid phosphatase-5b (p = 0.003) and N-terminal telopeptide-1 (p = 0.001) had increased in the ESRD patients after 12 weeks of bedside cycling. Bone-formative marker concentration was not altered in the exercise group after cycling.

Conclusion: Bone-formative marker concentrations increased with the severity of chronic kidney disease. Bone formative markers concentration increased along with CKD severity. We demonstrated the bone resorptive markers tartrate-resistant acid phosphatase-5b and N-terminal telopeptide-1 increased after intradialytic cycling in ESRD patients.

Keywords: N-terminal telopeptide-1; bone turnover; end-stage renal disease; intradialytic cycling; osteoporosis; tartrate-resistant acid phosphatase-5b.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare no conflicts of interest related to this study.

Figures

Figure 1
Figure 1
The flow chart of the clinical trial for ESRD participants.
Figure 2
Figure 2
Kaplan–Meier plot comparing the hospitalization (A) and overall survival rates (B) between the ESRD groups with and without the exercise intervention at the 1-year follow-up.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024; 105:S117–314. 10.1016/j.kint.2023.10.018 - DOI - PubMed
    1. Kazama JJ, Matsuo K, Iwasaki Y, Fukagawa M. Chronic kidney disease and bone metabolism. J Bone Miner Metab. 2015; 33:245–52. 10.1007/s00774-014-0639-x - DOI - PubMed
    1. Malluche HH, Mawad HW, Monier-Faugere MC. Renal osteodystrophy in the first decade of the new millennium: analysis of 630 bone biopsies in black and white patients. J Bone Miner Res. 2011; 26:1368–76. 10.1002/jbmr.309 - DOI - PMC - PubMed
    1. Nii-Kono T, Iwasaki Y, Uchida M, Fujieda A, Hosokawa A, Motojima M, Yamato H, Kurokawa K, Fukagawa M. Indoxyl sulfate induces skeletal resistance to parathyroid hormone in cultured osteoblastic cells. Kidney Int. 2007; 71:738–43. 10.1038/sj.ki.5002097 - DOI - PubMed
    1. Iwasaki Y, Kazama JJ, Yamato H, Matsugaki A, Nakano T, Fukagawa M. Altered material properties are responsible for bone fragility in rats with chronic kidney injury. Bone. 2015; 81:247–54. 10.1016/j.bone.2015.07.015 - DOI - PubMed

Publication types