ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: FR-OR037

Serum Sclerostin: A Useful Biomarker of CKD-MBD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • De maré, Annelies, University of Antwerp, Antwerp, ANTWERP, Belgium
  • D'Haese, Patrick, University of Antwerp, Antwerp, ANTWERP, Belgium
  • Behets, Geert J., University of Antwerp, Antwerp, ANTWERP, Belgium
  • Delanaye, Pierre, University of Liège, Liège, Belgium
  • Cavalier, Etienne, University of Liege, CHU Sart-Tilman, Liege, Belgium
  • Verhulst, Anja, University of Antwerp, Antwerp, ANTWERP, Belgium
  • Evenepoel, Pieter, University Hospitals Leuven, Leuven, Belgium

Sclerostin is a glycoprotein secreted by osteocytes and antagonizing the bone catabolic effects of the wnt/beta-catenin pathway. Mounting evidence indicates that circulating sclerostin may qualify as a biomarker of CKD-MBD. In this study we report data from a clinical study in which correlations between circulating sclerostin, skeletal sclerostin expression, bone histomorphometric parameters and serum markers of bone metabolism were investigated.


A transiliac bone biopsy was taken and serum samples were collected in a cohort of 68 ESRD patients (19 males) at the time of transplantation. Serum sclerostin levels were measured using 4 different commercially available assays (BioMedica, Diasorin, Tecomedical and R&D). Skeletal sclerostin expression was evaluated on immunohistochemically stained tissue sections by counting the % of sclerostin positive osteocytic lacunae. Quantitative bone histomorphometry was performed on Goldner stained undecalcified tissue sections. Different serum markers of bone metabolism were analysed using commercially available kits.


43 ± 13% of the osteocytic lacunae were positive for sclerostin expression. Median; interquartile range (IQR) serum sclerostin concentrations (pg/ml) with the 4 assays were: 213; 159 (R&D), 1155; 848 (Diasorin), 1687; 1501 (Tecomedical), 3109; 2524 (BioMedica). Despite these large inter-assay variation, significant correlations with the skeletal sclerostin expression were found for the 4 assays under study with the Biomedica assay showing the best correlation: Rs=0.3989, p<0.001. Furthermore, both skeletal and serum (except for the Diasorin assay) sclerostin levels negatively correlated with static bone histomorphometric and serum parameters reflecting bone metabolism (formation/-turnover/-mineralization) i.e. osteoid width (p<0.05), osteoblast perimeter (p<0.05), bone-specific alkaline phosphatase (p<0.05), N-terminal propeptide of type I collagen (p<0.01), PTH (p<0.01).


In ESRD patients, circulating sclerostin levels significantly correlate with skeletal expression of the protein and can be regarded as a metabolic bone marker. Further research investigating extra-osseous production (e.g. calcifying vascular smooth muscle cells) of sclerostin is warranted since variation in circulating sclerostin cannot be explained by its variation in skeletal expression only.


  • Government Support - Non-U.S.