[Biochemical markers of bone turnover. New aspect. Dialysis and bone metabolic marker]

Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There is increasing evidence suggesting that these disorders in mineral and bone metabolism are associated with increased risk for cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance dialysis. It is very important for dialysis patients to assess the mineral and bone abnormalities. Although bone biopsy is necessary to diagnosis of renal osteodystrophy in CKD-mineral and bone disorder (CKD-MBD) classification system, this technique is not recommended of routine evaluation for this bone disease. Bone metabolic markers, such as bone specific alkaline phosphatase and tartrate-resistant acid phosphatase isoform 5b, may be useful clinical indicator of bone turnover in CKD-MBD.