Chronic kidney disease–mineral and bone disorder (CKD-MBD) is a major complication of end-stage renal disease and is associated with increased morbidity and mortality. Sclerostin, an osteocyte-derived glycoprotein that inhibits the Wnt/β-catenin signaling pathway, has been implicated in the dysregulation of bone metabolism in dialysis patients. However, comparative data on sclerostin levels and their clinical determinants between hemodialysis (HD) and peritoneal dialysis (PD) patients remain limited, particularly in Southeast Asian populations. This cross-sectional study was conducted at Hue Central Hospital, Vietnam, between June 2023 and January 2026. A total of 89 end-stage renal disease patients were consecutively enrolled (HD: n = 51; PD: n = 38). Median serum sclerostin levels were 584. 21 (IQR: 301. 18–1479. 50) pg/mL in the HD group and 684. 21 (IQR: 407. 48–940. 35) pg/mL in the PD group, with no significant difference between groups (p = 0. 839). Serum sclerostin was inversely correlated with PTH in both HD (r = −0. 444, p = 0. 001) and PD patients (r = −0. 341, p = 0. 036). In the HD group, total femur BMD showed a significant inverse correlation with sclerostin (r = −0. 304, p = 0. 030). In multivariable analysis, LogPTH remained an independent predictor of sclerostin across all three sequential models in the HD group (Model 1: B = −0. 340, p = 0. 001; Model 2: B = −0. 270, p = 0. 035; Model 3: B = −0. 268, p = 0. 039; adjusted R2 range: 0. 197–0. 217) and in the combined HD + PD cohort (Model 1: B = −0. 271, p < 0. 001; Model 2: B = −0. 263, p < 0. 001; Model 3: B = −0. 249, p = 0. 003; adjusted R2 range: 0. 141–0. 158). In the PD subgroup, LogPTH was significant in Models 1 and 2 but not in Model 3; none of the models reached overall statistical significance (all p ≥ 0. 081), and findings should be considered exploratory given the limited sample size. Serum sclerostin levels did not differ significantly between HD and PD patients. PTH was the most consistent independent predictor of sclerostin across dialysis modalities and analytical models, underscoring its central role in CKD-MBD pathophysiology. Larger prospective multicenter studies are warranted to validate these findings and further clarify the clinical utility of sclerostin in dialysis populations.
Vo et al. (Fri,) studied this question.