Target Ranges and PTH Profile in A West African Population Using 2nd and 3rd Generation Tests

Abstract

Introduction: Bone metabolism disorders are one of the most frequent and serious complications of kidney disease, and are associated with high morbidity and mortality. In order to prevent these bone complications, the Kidney Disease Improving Global Outcomes (KDIGO) expert committee recommends maintaining PTH values within a target range dependent on the race of the population and the generation of test used. The aim of this study was to propose target intervals for monitoring PTH in Ivorian haemodialysis patients according to test generation, and to establish the PTH profile of these patients.
 Materials and Methods: This was an analytical cross-sectional study involving 86 black African subjects in apparent good health for the determination of PTH target intervals and 200 black African haemodialysis patients for the PTH profile. Target ranges were determined simultaneously on a 2nd generation Maglumi 800 and 3rd generation kit Vidas (Whole PTH) according to KDIGO (2009) recommendations. The PTH profile of hemodialysis patients was established in comparison with the pre-established target ranges.
 Results: The target PTH ranges for dialysis patients were 280.4 to 1261.8 pg/ml for the Maglumi kitÒ and 83.8 to 377.1 pg/ml for the Vidas kitÒ. The mean PTH value in healthy subjects was 21.99 pg/ml, compared with 473.3 pg/ml in haemodialysis patients. According to the target interval established on the VidasÒ kit, 34% of dialysis patients had a PTH value above the upper limit of normality and were therefore at risk of bone complications.
 Conclusion: The PTH values of black African Ivorian hemodialysis patients according to the pre-established target intervals were significantly higher in our population than those of Caucasian and Asian populations described in the literature.