Biological markers in the diagnosis of the different forms of renal osteodystrophy

Renal osteodystrophy continues to be a long-term complication associated with high rates of morbidity in patients with chronic renal failure. Although bone histomorphometry is the most reliable diagnostic method, several new biochemical markers of bone turnover have been proposed in recent years for the evaluation of bone remodelling in uremic patients. This review assesses the value and the limitations of serum markers of bone formation and resorption in the diagnosis of the major types of renal osteodystrophy. In addition, we consider the hypothetical role of serum beta 2-microglobulin and of some local mediators involved in the process of bone cell activation and inhibition, such as circulating cytokines and their inhibitors and receptors.