History

Back ground: The risk of fractures progressively increased with kidney function declines and in end-stage the kidney disease regarded as the risk of fractures is more 2 to 3 times higher compared to the general population. The gold standard for assessment of bone turnover is the measurement of bone formation rate in an iliac crest bone biopsy specimen. This is limited by expense, invasiveness and availability of local expertise. Plasma bone turnover markers were developed in osteoporosis patients for fracture risk prediction and assessment of medication compliance and anti-fracture efficacy. Therefore, the present study was aimed to evaluation the chemical biomarkers of bone integrity and to assessment the efficacy of these biomarkers as diagnostic and predictors biomarkers for early detection of complications of bone diseases in patients with chronic kidney disease. Methods. A case control study, involved 129 patient and 55 participants as control group. Cobas E311, C311 automated analyzer and ELISA technique were used to analysis the parameters. Results: The current study showed significant differences in the BMI (26.8), uric acid (4.34), urea (28.18), creatinine (0.76), phosphorus (3.42), calcium (9.12), vitamin D (31.55), albumin (4.30), alkaline phosphatase (74.49), bone specific alkaline phosphatase (1.83), parathyroid hormone (33.51), osteocalcin (1.84), pro-collagen type1 propeptide and estimated GFR (88.15) in control Acknowledgments\ in comparison with BMI (24.1), uric acid (6.53), urea (139.4), creatinine (7.69), phosphorus (6.309), calcium (8.813), vitamin D (15.14), albumin (3.79), alkaline phosphatase (120.2), bone specific alkaline phosphatase (11.85), parathyroid hormone (153.7), osteocalcin (9.392), pro-collagen type1 propeptide (3.08) and estimated GFR (19.47) in patient, respectively. In the present study were no significant differences between CKD patients and healthy control, regarding to age (P =0.07) and gender (P =0.629). There were highly significant increases of urea, creatinine, uric acid, osteocalcin, pro-collagen type propeptide and estimated GFR, parathyroid hormone, Phosphorous, ALP levels; whereas showed significant decreases of vitamin D, albumin, calcium levels compared to the control group. Conclusion: There were significant decreases in each of vitamin D in patient with CKD; While, there were significant increases in each of ferritin, bone alkaline phosphatase, osteocalcin, and pro-collagen type1 propeptide. They were good noninvasive biomarkers for prediction of bone turnover, risk stratification and assessment disease severity in CKD patients