Laboratory Evaluatoin Of Beta-Crosslap Levels In Children With Chronic Renal Failure And Their Correlation With Bone Resorption

renal osteodystrophy is one of the major complications in hemodialysis (hd) patients, leading to a substantial increase in fracture rate and increased morbidity and mortality ,it include spectrum of high turnover skeletal lesions with hyperparathyroidism and low turnover skeletal lesions (osteomalacia and adynamic bone disease).bone biopsy is the gold standard for the study of different subjects of rod but it is a painful and invasive procedure that is rarely performed in clinical practice and primarily serves as a research tool.so this current study was done to evaluate β-crosslap levels as a marker of bone resorption in children with crf and their correlation with total alkaline phosphatase as a marker of bone formation, ipth and bmd regarding z-score.the present study included 20 children with end stage renal failure on regular hemodialysis along with 10 healthy children as control group.bmd regarding z-score was significantly lower in patient group than control group. osteoprosis was found in 50%, osteopenia was found in 35% while 15% was normal in patient group.serum po4 was significantly higher in patient group than control group while serum ca is significantly lower in the patients group.ipth was significantly higher in patient group than control group. ipth ≥ 200pg/ml was detected in 75% in patient group suggesting high percent of high turnover bone lesions in hemodialysis children.alp (marker of bone formation) and β-crosslap (marker of bone resorption) were significantly higher in patients group than control group which reflect higher rates of bone formation and degradation in dialytic children.the increased serum β-crosslap reflects two different pathophysiological mechanisms: the collagen breakdown in renal osteodystrophy and the disturbed renal excretion.positive significant correlation was detected between β-crosslap, alp and ipth while negative correlation was detected between β-crosslap and bmd.