Serum BALP and TRAp-5b in Chronic kidney disease

• Research type

  Research Study

• Full title

  The role of serum bone specific alkaline phosphatase and Tartrate resistance acid phosphatase 5b in osteoporosis, patients with and without chronic kidney disease

• IRAS ID

  279778

• Contact name

  Nandini Rao

• Contact email

  nandinirao@nhs.net

• Sponsor organisation

  Research & Innovation Governance Manager

• Duration of Study in the UK

  1 years, 0 months, 1 days

• Research summary

  Chronic kidney disease (CKD) affecting 20% of patients in UK. CKD is classified into 5 stages and patients with CKD stage 5 have a fourfold higher risk of fragility fractures.
  Osteoporosis is associated with low bone mineral density (BMD) and an increased risk of fragility fractures. Dual energy X-ray absorptiometry (DEXA) is a well validated tool for the diagnosis of osteoporosis . DEXA predicts fracture risk across CKD stages however does not reflect changes in microarchitecture of bone.
  
  Bone disease in CKD is heterogeneous and a composite of metabolic disturbances and osteoporosis. Chronic kidney disease bone mineral disorder (CKD MBD) is the systemic effect of renal dysfunction on the bone and vascular calcification. There are various forms of renal bone diseases including osteodystrophy, osteomalacia, mixed renal bone disease and adynamic bone disease. CKD-MBD can be assumed to be occurring in subjects with stages 3–5 CKD and may coexist with osteoporosis. Differentiating between them is a priority to guide the treatment. Circulating bone turnover markers (BTM) are increasingly being used in the management of metabolic bone disorders.

  Data suggest that bone -specific alkaline phosphatase (BALP), may help to discriminate among the heterogeneous forms of renal bone disease. Tartrate-resistant acid phosphatase 5b (TRAp-5b) is a marker of bone resorption. There is emerging data that TRAP-5b is a surrogate resorption marker in CKD.

  In this study we aim to investigate the utility of TRAP-5b and BALP in patients with CKD stage 4-5. We aim to recruit 36 patients with CKD and 36 post-menopausal women with osteoporosis as controls.

  After reviewing patients in outpatient renal or metabolic bone clinic, baseline bloods samples will be collected at Denmark hill, as per standard care for osteoporosis management. One additional sample will be collected for BALP and TRAP-5b at the same time.

• REC name

  London - Camberwell St Giles Research Ethics Committee

• REC reference

  22/LO/0197

• Date of REC Opinion

  5 May 2022

• REC opinion

  Further Information Favourable Opinion