Clinical evaluation of two parathyroid hormone assays in the context of vitamin D supply in chronic kidney disease

2013 ◽  
Vol 154 (51) ◽  
pp. 2025-2036
Author(s):  
László Kovács ◽  
Éva Virágh ◽  
Dóra Balogh ◽  
Bernadette Kálmán ◽  
Zoltán Lőcsei ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Chronic Renal Failure ◽  
Vitamin D Deficiency ◽  
Intact Parathyroid Hormone ◽  
Hormone Levels ◽  
The Difference

Introduction: Parathyroid hormone levels provide important information in chronic renal failure. Aim: To compare parathyroid hormone levels measured by two assays in correlation with vitamin D supply. Method: Parathyroid hormone and 25-hydroxi-vitamin-D were determined in 104 patients (31 patients with chronic renal failure without renal replacement therapy, 36 patients treated with peritoneal dialysis and 37 patients treated with hemodialysis). Results: Good correlation was found between results of the two parathyroid hormone methods, but the intact parathyroid hormone levels were higher than the biointact values. 87% and 13% of the patients had vitamin-D deficiency and insufficiency, respectively. The frequency of serious vitamin-D deficiency was higher in the peritoneal dialysis than in the hemodialysis group. Intact parathyroid hormone levels were different in dialysed patients having vitamin-D-deficiency and insufficiency, and the difference was higher for the biointact than intact values. Negative correlation was detected between biointact parathyroid hormone and 25-hydroxivitamin-D in the hemodialysis group. Conclusions: Biointact parathyroid hormone levels better reflect the vitamin D supply and bone metabolism than intact levels, especially in hemodialysed patients. Orv. Hetil., 2013, 154(51), 2025–2036.

scholarly journals Parathyroid hormone: what are we measuring and does it matter?

2002 ◽  
Vol 39 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Aubrey Blumsohn ◽  
Amna Al Hadari
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Parathyroid Hormone ◽  
Chronic Renal Failure ◽  
Primary Hyperparathyroidism ◽  
Intact Parathyroid Hormone ◽  
Intact Pth ◽  
Improve Outcome ◽  
Shed Light ◽  
Improved Outcome

Immunometric assays claiming to determine intact parathyroid hormone (PTH) generally cross-react with N-truncated forms such as PTH(7-84). Laboratories need to examine the relevance of new assays with probable PTH(1-84) specificity. It is logical that assays should measure what they state they do. However, it seems unlikely that use of older 'intact' PTH assays will affect the clinical interpretation of results in primary hyperparathyroidism or vitamin D deficiency. It is plausible that appropriate application of new PTH assays could improve outcome in chronic renal failure. However, it has never been suggested that straightforward replacement of existing assays with new PTH(1-84) assays will lead to this improved outcome. A better understanding of PTH fragments and their interaction with PTH receptors may shed light on the relevance of different PTH assays. In the meantime, older technologies will continue to work well for the vast majority of patients.

scholarly journals To Study the Association of Parathyroid Hormone with Severe Anaemia in Chronic Renal Failure Patients

2021 ◽  
Vol 10 (10) ◽  
pp. 724-728
Author(s):  
Madhavi Sarkari ◽  
Mahim Mittal ◽  
Ashutosh Kumar Rai
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Parathyroid Hormone ◽  
Chronic Renal Failure ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Clinical History ◽  
Intact Parathyroid Hormone ◽  
Mineral And Bone Disorder ◽  
Cross Sectional

BACKGROUND Chronic kidney disease is defined as abnormalities of kidney structure or function, present for > 3 months, with implications for health. In India, the prevalence of chronic kidney disease (CKD), ranges from 0.79 % to 1.4 %. Secondary hyperparathyroidism (SHPT) is one of the less recognized reasons of anaemia in chronic kidney disease (CKD). In this study, we evaluated the role of SHPT as a cause of anaemia, and correlation of intact parathyroid hormone (iPTH) and haemoglobin (Hb) levels in chronic renal failure (CRF) patients on haemodialysis and also in CRF patients who are not on haemodialysis. METHODS This is an observational cross-sectional study done in the department of medicine in BRD Medical College, Gorakhpur, Uttar Pradesh, India, over a period of one year among a total of 101 patients. All patients underwent detailed clinical history, clinical examination & relevant biochemical investigations. RESULTS Parathyroid hormone level was found elevated in 82.2 % CRF patients in our study; out of these 76.2 % patients were severely anaemic. CONCLUSIONS Anaemia mainly normocytic & normochromic is a common complication of chronic kidney disease. Hormonal failure in CRF patients is very commonly reflected as anaemia & mineral and bone disorder (CKD-MBD). Parathyroid hormone was found elevated in most (82.2 %) of the CRF patients with anaemia. KEY WORDS Chronic Renal Failure (CRF), Intact Parathyroid Hormone (iPTH), Secondary Hyperparathyroidism (SHPT), Chronic Kidney Disease (CKD)

Distribution of Circulating Immunoreactive Components of Parathyroid Hormone in Normal Subjects and in Patients with Primary and Secondary Hyperparathyroidism: The Role of the Kidney and of the Serum Calcium Concentration

1979 ◽  
Vol 57 (5) ◽  
pp. 435-443 ◽  
Author(s):  
M. A. Dambacher ◽  
J. A. Fischer ◽  
W. H. Hunziker ◽  
W. Born ◽  
J. Moran ◽  
...  
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Parathyroid Hormone ◽  
Chronic Renal Failure ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Normal Subjects ◽  
Dependent Manner ◽  
Intact Pth ◽  
Calcium Dependent

1. The distribution of intact parathyroid hormone-(1–84) [PTH-(1–84)] and of its COOH-terminal fragments was determined in human serum by column chromatography. In addition to PTH-(1–84) (peak I), COOH-terminal fragments having molecular weights of approximately 4000–7000 (peak II) and immunoreactive components co-eluting with human PTH-(1–12) (peak III) were observed. 2. Mean concentrations of intact PTH-(1–84) and of its COOH-terminal fragments were significantly raised in chronic renal failure as compared with those of normal subjects. Mean amounts of peak II were higher in patients with chronic renal insufficiency than in nutritional vitamin D deficiency, in pseudohypoparathyroidism and in primary hyperparathyroidism, despite comparable amounts of PTH-(1–84). 3. In chronic renal failure as well as in a group of patients with vitamin D deficiency, pseudohypoparathyroidism and primary hyperparathyroidism and in controls, significant linear relations were found between the serum concentrations of calcium and log (peak II/peak I). Our findings suggest that the conversion of intact PTH-(1–84) into COOH-terminal fragments by the parathyroid glands (resulting in a raised secretion of fragments) and/or in peripheral organs may be directly related to the serum concentration of calcium. However, the degradation of the fragments may also be suppressed in a calcium-dependent manner.

Severe vitamin D deficiency in chronic renal failure patients on peritoneal dialysis

2006 ◽  
Vol 66 (10) ◽  
pp. 247-255 ◽  
Author(s):  
H. Taskapan ◽  
F.F. Ersoy ◽  
P.S. Passadakis ◽  
P. Tam ◽  
D.E. Memmos ◽  
...  
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Vitamin D Deficiency ◽  
Severe Vitamin

scholarly journals PREVALENCE OF VITAMIN D DEFICIENCY IN DIFFERENT GROUPS OF CHRONIC RENAL FAILURE PATIENTS

2015 ◽  
Vol 21 (3) ◽  
pp. 887-890 ◽  
Author(s):  
Bistra T. Galunska ◽  
◽  
Daniela I. Gerova ◽  
Dobrin N. Paskalev ◽  
Rositza Y. Zorcheva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Vitamin D Deficiency

Low Parathyroid Hormone Levels in Bedridden Geriatric Patients with Vitamin D Deficiency

2009 ◽  
Vol 57 (6) ◽  
pp. 1045-1050 ◽  
Author(s):  
Mikko P. Björkman ◽  
Antti J. Sorva ◽  
Juha Risteli ◽  
Reijo S. Tilvis
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Geriatric Patients ◽  
Hormone Levels

scholarly journals Associations between Serum-Intact Parathyroid Hormone, Serum 25-Hydroxyvitamin D. Oral Vitamin D Analogs and Metabolic Syndrome in Peritoneal Dialysis Patients: A Multi-Center Cross-Sectional Study

2014 ◽  
Vol 34 (4) ◽  
pp. 447-455 ◽  
Author(s):  
Jie Dong ◽  
Qin Wang ◽  
Meng-Hua Chen ◽  
Hui-Ping Zhao ◽  
Tong-Ying Zhu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Lower Risk ◽  
Intact Parathyroid Hormone ◽  
Oral Vitamin ◽  
Vitamin D Analogs ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Introduction Although previous studies have suggested associations between serum intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MS) in the general population, these associations are still uncharacterized in peritoneal dialysis (PD) patients. Methods In total, 837 prevalent PD patients from 5 centers in China were enrolled between April 1, 2011 and November 1, 2011. The demographic data, biochemical parameters and medical records were collected, except for serum 25(OH)D which was measured in 347 of 837 patients. The definition of MS was modified from National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATPIII). Results 55.4% of 837 patients were found to have MS. The median concentration of iPTH, 25(OH)D and doses of oral vitamin D analogs for participants with MS was significantly lower than those without MS. The iPTH, 25(OH)D values and doses of vitamin D analogs were all associated with one or more components of MS. After multivariate adjustment, Low serum iPTH values and oral vitamin D analogs, rather than serum 25(OH)D, were significantly associated with the presence of MS, abnormal fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HDL-C). Compared to iPTH < 130pg/mL, iPTH 130–585 pg/mL and > 585pg/mL were associated with a lower risk of MS with adjusted odds ratio (OR) of 0.59 and 0.33, respectively. Taking vitamin D analogs was also associated with a lower risk of MS with adjusted OR of 0.55. Conclusions Serum iPTH and the use of active vitamin D supplements rather than serum 25(OH)D were independently associated with the presence of MS in patients on PD.

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