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The Scientific World Journal
Volume 2012, Article ID 503945, 9 pages
http://dx.doi.org/10.1100/2012/503945
Clinical Study

Serum Bone Resorption Markers after Parathyroidectomy for Renal Hyperparathyroidism: Correlation Analyses for the Cross-Linked N-telopeptide of Collagen I and Tartrate-Resistant Acid Phosphatase

1Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 24205, Taiwan
2Department of Medicine, Show-Chwan Memorial Hospital and Department of Nursing, Meiho University, 542, Sec. 1 Chung-shan Road, Changhua 50008, Taiwan
3Division of Nephrology, Mackay Memorial Hospital and Department of Pharmacology, Taipei Medical University, No. 252, Wu-Hsing Street, Taipei City 11031, Taiwan
4Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Road, Neihu District, Taipei City 11490, Taiwan

Received 11 May 2012; Accepted 5 June 2012

Academic Editors: K. D. Burns and K. Furuichi

Copyright © 2012 Kuo-Chin Hung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients on long-term dialysis may develop secondary hyperparathyroidism (SHPT) with increased serum concentrations of bone resorption markers such as the cross-linked N-telopeptide of type I collagen (NTX) and type-5b tartrate-resistant acid phosphatase (TRAP). When SHPT proves refractory to treatment, parathyroidectomy (PTX) may be needed. Renal patients on maintenance HD who received PTX for refractory SHPT ( 𝑛 = 2 3 ) or who did not develop refractory SHPT (control subjects; 𝑛 = 2 5 ) were followed prospectively for 4 weeks. Serum intact parathyroid hormone (iPTH), NTX, TRAP, and bone alkaline phosphatase (BAP) concentrations were measured serially and correlation analyses were performed. iPTH values decreased rapidly and dramatically. BAP values increased progressively with peak increases observed at 2 weeks after surgery. NTX and TRAP values decreased concurrently and progressively through 4 weeks following PTX. A significant correlation between TRAP and NTX values was observed before PTX but not at 4 weeks after PTX. Additionally, the fractional changes in serum TRAP were larger than those in serum NTX at all times examined after PTX. Serum iPTH, TRAP, and NTX values declined rapidly following PTX for SHPT. Serum TRAP values declined to greater degrees than serum NTX values throughout the 4-week period following PTX.