Journal article
PTH assays in dialysis patients: Practical considerations
Seminars in dialysis, Vol.32(1), pp.9-14
01/01/2019
DOI: 10.1111/sdi.12743
PMID: 30168196
Abstract
Parathyroid hormone (PTH) 1-84 is the main biologically active hormone produced by the parathyroid cells. Circulating PTH molecules include the whole PTH 1-84 along with amino (N) and carboxyl (C) terminal fragments. While PTH is the best available noninvasive biomarker to assess bone turnover in dialysis patients, the biological roles of individual circulating PTH fragments are still not completely known. The understanding that there is an enormous variation in the target specificity of currently available PTH assays for different circulating forms of PTH has led to the evolution of assays from first to second then third generation. With a reduction in kidney function, there is a preferential increase in circulating C fragments and non-PTH 1-84 forms, resulting in a decrease in the ratio of PTH 1-84/non-PTH 1-84. However, there are also substantial differences in between-assay measurements, with several fold variations in results. Targets based on multiples of the upper limit of normal (ULN) should be used rather than PTH ranges using absolute iPTH values. To date, the second-generation PTH remains the most widely used assay. Current guidelines recommend following iPTH trends rather than absolute values. Herein, we highlight problems and challenges in PTH assays/measurements and their interpretations in dialysis patients.
Details
- Title: Subtitle
- PTH assays in dialysis patients: Practical considerations
- Creators
- Mohanad Soliman - University of KentuckyWaleed Hassan - University of KentuckyMaria Yaseen - University of KentuckyMadhumathi Rao - University of KentuckyB. Peter Sawaya - University of KentuckyAmr El-Husseini - University of Kentucky
- Resource Type
- Journal article
- Publication Details
- Seminars in dialysis, Vol.32(1), pp.9-14
- Publisher
- Wiley
- DOI
- 10.1111/sdi.12743
- PMID
- 30168196
- ISSN
- 0894-0959
- eISSN
- 1525-139X
- Number of pages
- 6
- Language
- English
- Date published
- 01/01/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984738096602771
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