Fischer, Dagmar-Christiane, Smith, Colette ORCID: 0000-0003-2847-3355, De Zan, Francesca, Bacchetta, Justine, Bakkaloglu, Sevcan A., Agbas, Ayse, Anarat, Ali, Aoun, Bilal, Askiti, Varvara, Azukaitis, Karolis ORCID: 0000-0001-7953-1338, Bayazit, Aysun, Bulut, Ipek Kaplan, Canpolat, Nur ORCID: 0000-0002-3420-9756, Borzych-Duzalka, Dagmara, Duzova, Ali, Habbig, Sandra, Krid, Saoussen, Licht, Christoph, Litwin, Mieczyslaw, Obrycki, Lukasz, Paglialonga, Fabio, Rahn, Anja, Ranchin, Bruno, Samaille, Charlotte, Shenoy, Mohan, Sinha, Manish D., Spasojevic, Brankica, Stefanidis, Constantinos J., Vidal, Enrico, Yilmaz, Alev, Fischbach, Michel, Schaefer, Franz, Schmitt, Claus Peter and Shroff, Rukshana ORCID: 0000-0001-8501-1072 (2021). Hemodiafiltration Is Associated With Reduced Inflammation and Increased Bone Formation Compared With Conventional Hemodialysis in Children: The HDF, Hearts and Heights (3H) Study. Kidney Int. Rep., 6 (9). S. 2358 - 2371. NEW YORK: ELSEVIER SCIENCE INC. ISSN 2468-0249

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Abstract

Background: Patients on dialysis have a high burden of bone-related comorbidities, including fractures. We report a post hoc analysis of the prospective cohort study HDF, Hearts and Heights (3H) to determine the prevalence and risk factors for chronic kidney disease-related bone disease in children on hemodiafiltration (HDF) and conventional hemodialysis (HD). Methods: The baseline cross-sectional analysis included 144 children, of which 103 (61 HD, 42 HDF) completed 12-month follow-up. Circulating biomarkers of bone formation and resorption, inflammatory markers, fibroblast growth factor-23, and klotho were measured. Results: Inflammatory markers interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein were lower in HDF than in HD cohorts at baseline and at 12 months (P < .001). Concentrations of bone formation (bone-specific alkaline phosphatase) and resorption (tartrate-resistant acid phosphatase 5b) markers were comparable between cohorts at baseline, but after 12-months the bone-specific alkaline phosphatase/tartrate-resistant acid phosphatase 5b ratio increased in HDF (P = .004) and was unchanged in HD (P = .44). On adjusted analysis, the bone-specific alkaline phosphatase/tartrate-resistant acid phosphatase 5b ratio was 2.66-fold lower (95% confidence interval, -3.91 to -1.41; P < .0001) in HD compared with HDF. Fibroblast growth factor-23 was comparable between groups at baseline (P = .52) but increased in HD (P < .0001) and remained unchanged in HDF (P = .34) at 12 months. Klotho levels were similar between groups and unchanged during follow-up. The fibroblast growth factor-23/klotho ratio was 3.86-fold higher (95% confidence interval, 2.15-6.93; P < .0001) after 12 months of HD compared with HDF. Conclusion: Children on HDF have an attenuated inflammatory profile, increased bone formation, and lower fibroblast growth factor-23/klotho ratios compared with those on HD. Long-term studies are required to determine the effects of an improved bone biomarker profile on fracture risk and cardiovascular health.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Fischer, Dagmar-ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smith, ColetteUNSPECIFIEDorcid.org/0000-0003-2847-3355UNSPECIFIED
De Zan, FrancescaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bacchetta, JustineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bakkaloglu, Sevcan A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Agbas, AyseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anarat, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aoun, BilalUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Askiti, VarvaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azukaitis, KarolisUNSPECIFIEDorcid.org/0000-0001-7953-1338UNSPECIFIED
Bayazit, AysunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bulut, Ipek KaplanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Canpolat, NurUNSPECIFIEDorcid.org/0000-0002-3420-9756UNSPECIFIED
Borzych-Duzalka, DagmaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duzova, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Habbig, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krid, SaoussenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Licht, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Litwin, MieczyslawUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Obrycki, LukaszUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paglialonga, FabioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rahn, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ranchin, BrunoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samaille, CharlotteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shenoy, MohanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sinha, Manish D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spasojevic, BrankicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stefanidis, Constantinos J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vidal, EnricoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yilmaz, AlevUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischbach, MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefer, FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitt, Claus PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shroff, RukshanaUNSPECIFIEDorcid.org/0000-0001-8501-1072UNSPECIFIED
URN: urn:nbn:de:hbz:38-606723
DOI: 10.1016/j.ekir.2021.06.025
Journal or Publication Title: Kidney Int. Rep.
Volume: 6
Number: 9
Page Range: S. 2358 - 2371
Date: 2021
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 2468-0249
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CHRONIC KIDNEY-DISEASE; GROWTH-FACTOR 23; LEFT-VENTRICULAR HYPERTROPHY; TNF-ALPHA; ONLINE HEMODIAFILTRATION; CLINICAL-PRACTICE; VASCULAR CALCIFICATION; SYSTEMIC INFLAMMATION; ALKALINE-PHOSPHATASE; BIOCHEMICAL MARKERSMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60672

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