The relationship between intact PTH and biointact PTH (1–84) with bone and mineral metabolism in pre-dialysis chronic kidney disease (CKD)

O’Flaherty, David; Sankaralingam, A.; Scully, Paul; Manghat, P.; Goldsmith, David; Hampson, Geeta

doi:10.1016/j.clinbiochem.2013.06.023

Cited by 16 publications

(12 citation statements)

References 20 publications

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“…Bio-intact PTH concentrations measured by third-generation assays were consistently lower than intact PTH concentrations, but the differences varied [14151617]. Two studies reported differences similar to those found in our study [1417], whereas two other studies found a smaller difference [1516].…”

Section: Discussionsupporting

confidence: 69%

“…However, few studies have compared PTH results between the second- and third-generation assays for different stages of CKD [14151617]. The present study evaluated the correlation between the third-generation Liaison 1–84 PTH assay (bio-intact PTH) and the Cobas, second generation PTH assay (intact PTH) among CKD patients varying in illness severity from stage 3 through stage 5.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Intact PTH and Bio-Intact PTH Assays Among Non-Dialysis Dependent Chronic Kidney Disease Patients

et al. 2017

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BackgroundThe third-generation bio-intact parathyroid hormone (PTH) (1–84) assay was designed to overcome problems associated with the detection of C-terminal fragments by the second-generation intact PTH assay. The two assays have been compared primarily among dialysis populations. The present study evaluated the correlations and differences between these two PTH assays among patients with chronic kidney disease (CKD) stages 3 to 5 not yet on dialysis.MethodsBlood samples were collected from 98 patients with CKD stages 3 to 5. PTH concentrations were measured simultaneously by using the second-generation - PTH intact-STAT and third-generation bio-intact 1–84 PTH assays. Other serum biomarkers of bone mineral disorders were also assessed. CKD stage was calculated by using the CKD-Epidemiology Collaboration (EPI) formula.ResultsSerum bio-intact PTH concentrations were strongly correlated but significantly lower than the intact PTH concentrations (r=0.963, P<0.0001). This finding was consistent among CKD stages 3 to 5. PTH concentrations by both assays (intact and bio-intact PTH) positively correlated with urea (r=0.523, r=0.504; P=0.002, respectively), phosphorus (r=0.532, r=0.521; P<0.0001, respectively) and negatively correlated with blood calcium (r=−0.435, r=−0.476; P<0.0001, respectively), 25(OH) vitamin D, (r=−0.319, r=−0.353; respectively, P<0.0001) and the estimated glomerular filtration rate (r=−0.717, r=−0.688; P<0.0001, respectively).ConclusionsAmong patients with CKD stages 3 to 5 not on dialysis, the bio-intact PTH assay detected significantly lower PTH concentrations compared with intact PTH assay. Additional studies that correlate the diagnosis and management of CKD mineral and bone disorders with bone histomorphometric findings are needed to determine whether bio-intact PTH assay results are better surrogate markers in these early stages of CKD.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Comparison of Intact PTH and Bio-Intact PTH Assays Among Non-Dialysis Dependent Chronic Kidney Disease Patients

et al. 2017

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“…This study also found an increased fracture risk even in children who have lower tibia pQCT [45]. The latter was superior due to a better correlation with bone metabolism and bone density in one study [48]. In the laboratory investigation of CKD, PTH still plays a major role as it correlates with bone turnover, even though target levels in children have not been agreed on.…”

Section: Diagnostic Approachmentioning

confidence: 65%

Renal osteodystrophy in children

Kemper

Husen

2014

Current Opinion in Pediatrics

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“…In a study by Tan et al ( 18 ), Elecsys PTH (1-84) was strongly associated with iPTH as well as with serum level of alkaline phosphatase as similarly obtained in our study. In another study by O’Flaherty et al ( 19 ), however, the level of iPTH was significantly higher than 1-84 PTH. In a study by Hecking et al ( 20 ), not only two assays had strong association, but also iPTH was strongly associated with serum phosphorus and creatinine.…”

Section: Discussionmentioning

confidence: 76%

Comparing the values of intact parathormone and 1– 84 PTH to predict hyperparathyroidism in hemodialysis patients

2017

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Background: Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD) leading high mortality and even long-term morbidity. SHPT is manifested by elevation of parathyroid hormone (PTH) and accurate determining the level of serum PTH is very essential for early diagnosis of SHPT secondary to CKD. It is very important to match the values obtained for intact parathormone (iPTH) and 1– 84 PTH with the minimized measurement bias. Objectives: The present study aimed to first determine the agreement value between the iPTH and 1– 84 PTH measures in patients with hyperparathyroidism secondary to endstage renal disease under chronic hemodialysis. Then, we attempted to determine the best cutoff values for these two measurements for detecting SHPT in such patients. Patients and Methods: This cross-sectional study was conducted on hemodialysis patients. The value of study biomarkers including iPTH and 1– 84 PTH was assessed. Results: A strong positive association was revealed between the two indicators of iPTH and 1-84 PTH (r = 0.800, P < 0.001). The linear association between these two parameters is independent to baseline characteristics including gender, age, body mass index, and medical history. Among all biochemical elements, the value of 1-84 PTH was only associated with serum calcium level negatively (r = -0.267, P = 0.027) and alkaline phosphatase positively (r = 0.359, P = 0.003). Considering iPTH as the reference and according to the area under the ROC curve (AUC), 1-84 PTH had high value to predict hyperparathyroidism (AUC = 0.926, P < 0.001). The best cutoff point for 1-84 PTH to discriminate hyperparathyroidism from normal condition was 60 yielding a sensitivity of 92.3% and a specificity of 79.1%. Among other baseline laboratory parameters, only alkaline phosphatase had an acceptable value for diagnosing hyperparathyroidism (AUC = 0.731, P = 0.001). Conclusions: The measurement of both iPTH and 1-84 PTH is valuable for predicting hyperparathyroidism secondary to CKD, but according to lower cost and comparableeffectiveness of iPTH measurement, this assay may be comparable to 1-84 PTH to predict this consequence.

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The relationship between intact PTH and biointact PTH (1–84) with bone and mineral metabolism in pre-dialysis chronic kidney disease (CKD)

Cited by 16 publications

References 20 publications

Comparison of Intact PTH and Bio-Intact PTH Assays Among Non-Dialysis Dependent Chronic Kidney Disease Patients

Comparison of Intact PTH and Bio-Intact PTH Assays Among Non-Dialysis Dependent Chronic Kidney Disease Patients

Renal osteodystrophy in children

Comparing the values of intact parathormone and 1– 84 PTH to predict hyperparathyroidism in hemodialysis patients

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