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The relation between renal function and serum sclerostin in adult patients with CKD

Solenne Pelletier1, Laurence Dubourg, Marie-Christine Carlier

  • 1Département de Néphrologie, Hôpital E. Herriot and Université de Lyon, Lyon, France. Solenne.pelletier@chu-lyon.fr

Clinical Journal of the American Society of Nephrology : CJASN
|February 23, 2013
PubMed

Insights

Serum sclerostin levels increase with declining kidney function, even in early stages of chronic kidney disease (CKD). GFR, sex, and phosphate levels are key factors, not age, suggesting potential interventions for managing sclerostin in CKD patients.

Area of Science:

  • Nephrology
  • Endocrinology
  • Bone Metabolism

Background:

  • Sclerostin is a bone antianabolic peptide implicated in osteoporosis.
  • Elevated sclerostin is observed in patients with end-stage renal disease (ESRD) on maintenance dialysis.
  • Data on sclerostin levels in early chronic kidney disease (CKD) were lacking.

Purpose of the Study:

  • To investigate serum sclerostin levels in patients with early stages of CKD.
  • To identify factors associated with sclerostin levels in this population.

Main Methods:

  • Serum sclerostin and glomerular filtration rate (GFR) were measured in 90 CKD patients.
  • Inulin clearance was used to calculate GFR.
  • Fasting blood samples were analyzed for calcium, phosphorus, parathyroid hormone, bone alkaline phosphatase, and 25-OH vitamin D.

Main Results:

  • Higher sclerostin levels were observed starting at CKD stage III and increased with declining GFR.
  • Sclerostin levels were significantly higher in men than women.
  • Serum sclerostin showed an inverse relationship with GFR and a positive correlation with serum phosphate and age.
  • Multiple regression analysis identified GFR, sex, and serum phosphate as significant predictors of sclerostin levels.

Conclusions:

  • This study is the first to report elevated serum sclerostin levels in patients with CKD stage III.
  • GFR, sex, and serum phosphate are the primary determinants of sclerostin levels in CKD.
  • The association between age and sclerostin may be confounded by reduced renal function in older individuals.
  • Targeting serum phosphorus levels could potentially lower sclerostin levels in CKD patients.
Abstract

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