Serum Sclerostin Level in Relation to Bone Status in Children with Chronic Kidney Disease

Abstract

Abstract Background: To assess the serum level of sclerostin as a bone marker in children with different stages of Chronic Kidney Disease and its relation to bone status in children with CKD. Aime of Study: Is to assess the serum level of sclerostin in children with different stages of CKD and its relation to bone status in those children. Patients and Methods: The study was conducted on total of 90 children, 60 children of them were followed-up for diagnosis of CKD stages from II to V at Mansoura University Children Hospital (MUCH) Nephrology Unit. This study was done from March 2015 to March 2016. They were 34 (56.7%) males and 26 (43.3%) females with mean age SD of 11.06±3.4. Control group of 30 healthy children and were 18 male (60%) and 12 (40%) female with mean age SD of 9.6±2.3. Age ranges from three to seventeen years, complete blood picture, serum creatinine, parathyroid hormone, alkaline phosphatase, calcium, phosphorous and sclerostin serum level and also DEXA scan were measured in both groups. All patients were free from acute illness or symptoms suggestive of a urinary infection in the previous 3 months and none of them were receiving corticosteroids. Children with CKD who have diabetes, vascular calcifications or had undergone renal transplantation were excluded. Results: Elevated serum sclerostin in CKD & ESRD groups compared to control. Non-significant correlation between serum sclerostin level, biochemical bone markers and different anthropometeric measures. Conclusions: Serum sclerostin was elevated in CKD & ESRD suggesting as an indicator of bone mineral density in CKD patients but it is level didn't correlate as expected with observed BMD or bone turnover markers, suggesting presence of confounding variables that must be taken into account before routine clinical implementation. Non-significant cor-relation between serum sclerostin level and other biochemical bone markers as regard Calcium, phosphate, alkaline phos-phatase and patathemone hormone. Non-significant correlation was also detected between sclerostin, bone mineral density and body composition.