Associations of Changes in Bone Turnover Markers with… : Clinical Journal of the American Society of Nephrology
mone, bone-specific alkaline phosphatase (BALP), intact procollagen type I N-terminal propeptide (PINP), and tartrate-resistant acid phosphatase isoform 5b (TRAP5b) measured at 0, 3, and 12 months post-transplant (N=209). Paired transiliac bone biopsies were available in a subset (n=49). Between-group differences were evaluated by Student’s t test, Wilcoxon signed-rank test, or Pearson’s chi-squared test. Results Changes in BMD varied from –22% to +17%/yr. Compared with patients with no change (±2.5%/yr), patients who gained BMD had higher levels of parathyroid hormone (236 versus 136 pg/ml), BALP (31.7 versus 18.8 μg/L), and Intact PINP (121.9 versus 70.4 μg/L) at time of transplantation; a greater decrease in BALP (−40% versus −21%) and Intact PINP (−43% versus −13%) by 3 months; and lower levels of Intact PINP (36.3 versus 60.0 μg/L) at 12 months post-transplant. Patients who lost BMD had a less marked decrease, or even increase, in Intact PINP (+22% versus −13%) and TRAP5b (−27% ve