scholarly journals P0831HIGH SERUM ALKALINE PHOSPHATASE PREDICTS THE RISK OF CKD PROGRESSION: EFFECT NODIFICATION BY THE GFR

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Francesca Mallamaci ◽  
Graziella D'arrigo ◽  
F Marino ◽  
Graziella Caridi ◽  
Giovanna Parlongo ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Normal Range ◽  
Ckd Progression ◽  
Effect Modifier ◽  
End Point ◽  
Traditional Age ◽  
Hs Crp ◽  
Post Hoc ◽  
The Relationship

Abstract Background and Aims In the post-hoc analyses of the SUSTAIN and ASSURE trials (Kidney Blood Press Res. 2018;43:449-457), Apabetalone, an epigenetic modulator which lowers serum alkaline phosphatase (AlkPhos), stabilized the GFR in patients with cardiovascular disease and a GFR <60/ml/min/1.73m2. Analyzing the relationship between AlkPhos and renal outcomes in patients with established CKD is useful to preliminarily explore the biological hypothesis that AlkPhos is implicated in CKD progression. Method We investigated the relationship between AlkPhos and the risk for a combined renal end-point (30% GFR loss or dialysis/renal transplantation) in a cohort of 609 stage 3-5 CKD patients with an average GFR of 34.8±12.1ml/min/1.73 m2. Results Median AlkPhos levels were 91 IU/L (Interquartile range 71-117 IU/L) and in the vast majority of patients had values below 147 IU/L (the upper limit of the normal range). Over a median follow up of 3 years, two-hundred patients had the combined renal end-point. In an unadjusted analysis 1 ln increase in AlkPhos entailed a 49% risk excess for the renal end-point (HR: 1.49, 95% CI 1.11-2.01, P=0.008). Adjusting for traditional (age, gender, smoking, diabetes, total cholesterol, BMI, systolic BP, CV comorbidities) and CKD specific risk factors (hemoglobin, albumin, phosphate, and hs-CRP) did not modify the strength of this association (HR:1.48, 95% CI 1.08-2.02, P=0.016). Furthermore, In a fully adjusted analysis testing the GFR as an effect modifier of the AlkPhos - combined renal end point relationship showed a strong GFR- AlkPhos interaction (Figure). Indeed the risk for the combined renal end-point was gradually more pronounced at progressively more severe degrees of renal dysfunction, the HR being 0.94 (CI95% 0.60-1.47) at a GFR of 40 ml/min/m2 and 2.71 (CI95% 1.49-4.93) at 10 ml/min/1.73m2. Conclusion In patients with stage 3-5 CKD alkaline phosphatase within the normal range is associated with the risk for progression to ESRD and the GFR is an effect modifier of this relationship. Findings in this study are compatible with the hypothesis that within the normal range of this biomarker, the risk for CKD progression by alkaline phosphatase is amplified by the severity of CKD. These data are in keeping with post-hoc analyses of the SUSTAIN and ASSURE trials and provide circumstantial support to the hypothesis that interventions lowering serum alkaline phosphatase may mitigate CKD progression.

Serum alkaline phosphatase: normal values by sex and age.

1977 ◽  
Vol 23 (9) ◽  
pp. 1769-1770 ◽  
Author(s):  
J R Eastman ◽  
D Bixler
Keyword(s):  
Alkaline Phosphatase ◽  
Enzyme Activity ◽  
Statistical Analysis ◽  
Normal Values ◽  
Serum Alkaline Phosphatase ◽  
Blood Type ◽  
Sample Population ◽  
Normal Range ◽  
Larger Sample ◽  
Alkaline Phophatase

Abstract We report here the normal range of serum alkaline phophatase activity as measured by the method proposed by Hausamen et al. [Clin. Chim. Acta 15, 241 (1967)] with a much larger sample size than used in previous investigations. In the statistical analysis the sample population is subdivided by sex and age, two variables which are known to influence enzyme activity. No statistically significant influence of blood type on enzyme activity was observed. The normal range of enzyme activity is reported in percentiles.

scholarly journals An association between time-varying serum alkaline phosphatase concentrations and mortality rate in patients undergoing peritoneal dialysis: a five-year cohort study

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Ying Liu ◽  
Jin-Gang Zhu ◽  
Ben-Chung Cheng ◽  
Shang-Chih Liao ◽  
Chih-Hsiung Lee ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Alkaline Phosphatase ◽  
Peritoneal Dialysis ◽  
Serum Alkaline Phosphatase ◽  
Urine Volume ◽  
Time Dependent ◽  
Time Varying ◽  
Cox Models ◽  
Death Risk ◽  
The Relationship

Abstract The relationship between serum alkaline phosphatase (ALP) concentrations and mortality in peritoneal dialysis (PD) patients is rarely reported. We enrolled 667 PD patients in one PD centre in Taiwan to retrospectively examine the association between three ALP concentrations (baseline, time-averaged, time-dependent) and mortality over a 5-year period (2011–2015). Baseline data collection included demographics, clinical, and laboratory parameters. Multivariable-adjusted Cox models were used to analyse the association. Four ALP quartiles were defined at the baseline: ≤62, 63–82, 83–118, and ≥119 U/L. Of 667 patients, 65 patients died, of which 8 patients died due to cardiovascular disease. Females were predominant in the higher ALP quartiles, and 24-h urine volume was significantly proportionately decreased in the higher ALP quartiles. ALP quartiles expressed by the three models were not associated with all-cause or cardiovascular mortalities after adjusting for demographics, liver function, bone metabolism, mortality, hemoglobin, and 24-h urine volume. In conclusion, ALP concentrations were not associated with death risk in PD patients over the 5-year period.

scholarly journals Effect modification by ferritin on the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance

2020 ◽  
Author(s):  
Angela Sciacqua ◽  
Ettore Ventura ◽  
Giovanni Tripepi ◽  
Velia Cassano ◽  
Graziella D'Arrigo ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Glucose Tolerance ◽  
Iron Homeostasis ◽  
High Sensitivity ◽  
Oral Glucose ◽  
Effect Modifier ◽  
Hypertensive Patients ◽  
Matsuda Index ◽  
Hs Crp ◽  
The Relationship

Abstract Backgroud: Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance.Methods: We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was definied by carotid-femoral pulse wave velocity (PWV).Results: Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin.Conclusion: Ferritin represents an independent predictor of AS in our study population and a strong effect modifier on the relationship between inflammation and PWV.

Use of a New Assay in a Study of Serum Alkaline Phosphatase Levels in 2000 Hospital Patients

1960 ◽  
Vol 6 (5) ◽  
pp. 495-500 ◽  
Author(s):  
Arthur L Babson ◽  
Prunella A Read ◽  
George E Phillips ◽  
Hugh F Luddecke
Keyword(s):  
Alkaline Phosphatase ◽  
Normal Values ◽  
Serum Alkaline Phosphatase ◽  
Normal Range ◽  
Preliminary Screening ◽  
Clinical Interpretation ◽  
Hospital Patients

Abstract Serum alkaline phosphatase determinations performed with a commercially available tablet procedure for rapid semiquantitative assay gave results that were found to be reliable and in agreement with quantitative assays performed by the Bodansky procedure. In a study of the sera of 2000 hospital patients, more than 70 per cent of all the assays requested yielded normal values. Since precise determinations in the normal range are generally not required for clinical interpretation, routine use of the semiquantitative test for preliminary screening would have eliminated this percentage of the tedious quantitative assays.

scholarly journals Ferritin modifies the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance

2020 ◽  
Author(s):  
Angela Sciacqua ◽  
Ettore Ventura ◽  
Giovanni Tripepi ◽  
Velia Cassano ◽  
Graziella D'Arrigo ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Glucose Tolerance ◽  
Iron Homeostasis ◽  
High Sensitivity ◽  
Oral Glucose ◽  
Effect Modifier ◽  
Hypertensive Patients ◽  
Matsuda Index ◽  
Hs Crp ◽  
The Relationship

Abstract Backgroud: Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance.Methods: We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was defined by carotid-femoral pulse wave velocity (PWV). Results: Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin.Conclusion: Ferritin represents an independent risk factor of arterial stiffness in our study population and a strong effect modifier on the relationship between inflammation and PWV. However, further studies are needed to fully elucidate the potential role of this biomarker in human atherosclerosis.

THE RELATIONSHIP BETWEEN SERUM ALKALINE PHOSPHATASE AND DIETARY ESSENTIAL AMINO ACIDS

1949 ◽  
Vol 27e (1) ◽  
pp. 25-30 ◽  
Author(s):  
Jules Tuba ◽  
Max M. Cantor ◽  
A. Gerald Richards
Keyword(s):  
Amino Acids ◽  
Alkaline Phosphatase ◽  
Serum Alkaline Phosphatase ◽  
Essential Amino Acids ◽  
Serum Alkaline Phosphatase Activity ◽  
Low Protein ◽  
Fat Mobilization ◽  
Weanling Rats ◽  
Barley Protein ◽  
The Relationship

It has been found that, when weanling rats are placed on a diet containing low protein barley (protein = 8.5%) or on diets containing low protein barley with supplements of casein or individual essential amino acids, with the exception of lysine and methionine, the level of serum alkaline phosphatase is related in an inverse fashion to the rate of growth. The addition to the basal low protein diet of methionine or casein, i.e., of labile methyl groups, results in the lowering of serum alkaline phosphatase activity towards normal levels. This is considered to reflect a return to normal of fat mobilization.

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