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Bone alkaline phosphatase: An important biomarker in chronic kidney disease - mineral and bone disorder

Adrien Nizet1, Etienne Cavalier1, Peter Stenvinkel2

  • 1Department of Clinical Chemistry, University Hospital Center of Liège, University of Liège, Liège, Belgium.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|November 18, 2019
PubMed

Insights

Bone alkaline phosphatase (BALP) is a key factor in chronic kidney disease mineral and bone disorder (CKD-MBD). BALP shows promise as a more reliable biomarker and treatment target for cardiovascular risk in CKD patients.

Area of Science:

  • Biochemistry
  • Nephrology
  • Cardiology

Background:

  • Cardiovascular morbidity and mortality are elevated in chronic kidney disease (CKD).
  • CKD-MBD, a disorder of mineral and bone metabolism, contributes to cardiovascular pathology and risk.
  • Bone alkaline phosphatase (BALP) plays a role in biomineralization and vascular calcification.

Purpose of the Study:

  • To review the characteristics of alkaline phosphatase isozymes and assays.
  • To discuss the role of BALP in physiological and pathological mineralization.
  • To evaluate the clinical benefit of BALP determination in CKD.

Main Methods:

  • Literature review of BALP characteristics, assays, and clinical studies.
  • Analysis of BALP's role in biomineralization and vascular calcification.
  • Comparison of BALP with parathyroid hormone (PTH) as a biomarker in CKD-MBD.

Main Results:

  • BALP is crucial in vascular calcification and a predictor of mortality in CKD.
  • Serum BALP exhibits lower variability than PTH, making it suitable for diagnosis and monitoring.
  • BALP's linear association with mortality offers advantages over PTH's U-shaped curve for treatment targeting.

Conclusions:

  • BALP is a promising biomarker and potential treatment target for CKD-MBD.
  • BALP determination offers clinical benefits for managing cardiovascular risk in CKD patients.
  • Further research into BALP assays and clinical applications is warranted.

Keywords:
Alkaline phosphataseBone formationChronic kidney diseaseMineralizationMortalityVascular calcification

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