Study ID Possible relationship between NGAL and CKD-MBD in dialysis

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Circulating Neutrophil Gelatinase Associated Lipocalin (NGAL) is associated with markers of chronic kidney disease, mineral bone disorders (CKD-MBD) in hemodialysis patients, according to a new study.

“These results suggest that NGAL is a participant in CKD-MBD under [maintenance hemodialysis] conditions, ”Dong-mei Xu, MD, and colleagues at the First Affiliated Hospital of Shandong First Medical University in Jinan, China, wrote in the Journal of Bone and Mineral Metabolism.

NGAL plasma was positively and significantly correlated with serum calcium, phosphate, and alkaline phosphatase (ALP) in adjusted analyzes of data from 105 patients on hemodialysis, investigators reported. In addition, 12 patients who underwent parathyroidectomy with autotransplantation (PTx + AT) for severe secondary hyperparathyroidism saw their plasma NGAL decrease from 715.84 to 688.42 ng / mL in the week following surgery, although not significant.


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The researchers adjusted for a range of possible confounding factors, including age, sex, dialysis year, albumin, and CKD-MBD parameters (calcium, phosphate, ALP, intact parathyroid hormone, Klotho, and fibroblast growth factor 23).

The positive correlations between circulating NGAL and ALP, calcium and the decline of NGAL after PTx + AT “suggest that bone may be one of the main sources of increase in NGAL in [maintenance hemodialysis] the patients.”

The study lacked data on bone mineral density, vascular calcification, and sequelae of CKD-MBD, such as fractures, cardiovascular disease, and death. Investigators suggested examining these variables in future research.

“To our knowledge, this is the first study to find an association between NGAL and ALP in patients [receiving maintenance hemodialysis], and this finding suggests that NGAL may be important for the increasingly well-known crosstalk between bone and vessels.

Reference

Jia XY, Wei K, Chen J et al. Association of gelatinase-associated plasma neutrophil lipocalin with CKD-MBD parameters in patients on maintenance hemodialysis. J Bone Miner Metab. Published online August 15, 2021. doi: 10.1007 / s00774-021-01248-9

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