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The novel bone alkaline phosphatase B1x isoform in children with kidney disease

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Abstract

The bone alkaline phosphatase (BALP) B1x isoform has previously only been identified in some adults with chronic kidney disease on dialysis and in human bone tissue. Twenty-nine patients, 3–20 years of age, with reduced renal function due to a variety of kidney diseases were examined. We measured parathyroid hormone (PTH), biointact (whole 1–84) PTH, osteoprotegerin (OPG), CrossLaps (CTX), tartrate-resistant acid phosphatase isoform 5b (TRACP 5b) type I procollagen intact amino-terminal propeptide (PINP), osteocalcin, total alkaline phosphatase (ALP), and BALP isoforms B/I, B1x, B1, and B2. Fifty percent higher levels were detected of PTH vs. biointact PTH, demonstrating non-(1–84) PTH fragments detected by the PTH assay. Increased activities were found in five, four, and three patients for total ALP, B1, and B2, respectively. Sixteen (55%) patients had increased B/I levels. B1x was identified in two (7%) patients, who had OPG levels in the higher range independently of age, glomerular filtration rate (GFR), and biointact PTH. B1x was identified prior to and after 9 days of growth hormone (GH) therapy in one patient but not after 1, 3, 6, and 12 months, however. In conclusion, our study demonstrates that the novel BALP B1x isoform is occasionally found to be present in children with kidney disease but to a lesser degree in comparison with adults with chronic kidney disease on dialysis. It is essential to perform bone histomorphometry for future investigations in order to elucidate the exact nature of circulating B1x in patients with kidney disease for accurate classification of type of renal bone disease.

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Acknowledgments

We are grateful to Cecilia Linder and Christina Linnér for excellent technical assistance. This study was supported by grants from the Swedish Research Council, the Swedish Society of Medicine, the County Council of Östergötland, the Magn. Bergvalls Foundation, the Åke Wiberg Foundation, the Sahlgrenska University Foundation, the R&D Council in Göteborg and Southern Bohuslän, the Swedish Association for Kidney Patients, and Första Majblommans Riksförbund.

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Authors and Affiliations

  1. Department of Pediatrics, The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Göteborg University, SE-416 85, Göteborg, Sweden

    Diana Swolin-Eide & Sverker Hansson

  2. Division of Clinical Chemistry, Laboratory Medicine Center, Linköping University Hospital, SE-581 85, Linköping, Sweden

    Lasse Larsson & Per Magnusson

  3. Bone and Mineral Metabolic Unit, Division of Clinical Chemistry, Department of Biomedicine and Surgery, Faculty of Health Sciences, SE-581 85, Linköping, Sweden

    Per Magnusson

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  1. Diana Swolin-Eide
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  2. Sverker Hansson
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  3. Lasse Larsson
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  4. Per Magnusson
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Correspondence to Per Magnusson.

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Swolin-Eide, D., Hansson, S., Larsson, L. et al. The novel bone alkaline phosphatase B1x isoform in children with kidney disease. Pediatr Nephrol 21, 1723–1729 (2006). https://doi.org/10.1007/s00467-006-0231-2

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