Comparison between a second and a third generation parathyroid hormone assay in hemodialysis patients

Gannagé‐Yared, Marie‐Hélène; Fares, Chirine; Ibrahim, Tony; Rahal, Zeina Abou; Elias, Michelle; Chelala, Dania

doi:10.1016/j.metabol.2013.05.007

Cited by 13 publications

(7 citation statements)

References 28 publications

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“…ey concluded that Elycsys PTH (1-84) has a comparable precision and good correlation with "intact" assays; "intact" assays correlated well among each other but showed discrepancy with increasing PTH concentrations [10]. Another study compared a third-generation assay (Liaison, DiaSorin) with a second-generation assay (ELSA-PTH, Cis biomedical) in a population of dialyzed patients, and also, in this study, the two kits showed a good correlation, independently from age, sex, BMI, and blood pressure, but also, in this study, differences between the two assays increased with the rise of PTH values [11]. e aim of our study is to compare the two generations of PTH assays in healthy subjects, indeed this data is still not available in the literature.…”

Section: Discussionsupporting

confidence: 62%

PTH: Redefining Reference Ranges in a Healthy Population—The Role of Interfering Factors and the Type of Laboratory Assay

Censi

Iacobone

Simmini

et al. 2020

International Journal of Endocrinology

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Introduction. Parathyroid hormone (PTH) is a linear peptide constituted by 84 amino acids and active in its 1-84 form, but a wide range of PTH forms produced by its post-transcriptional modifications are present in blood. Many assays with different specificities are commercially available. e aim of our study was to compare a 2 nd and 3 rd generation in healthy population in order to better define the reference range in the healthy population residing in our region. Materials and Methods. 108 subjects (53 females and 55 males) referring to the transfusion donor were enrolled in the study centre in April 2016 and underwent PTH levels measurements with a 3 rd generation kit (chemiluminescent immunoassay DiaSorin Liaison) and with a 2 nd generation kit (immunoradiometric assay Total Intact PTH Assay (Coated Tube), Scantibodies). Also calcium, phosphate, creatinine, and 25OHD3 were measured. A questionnaire on lifestyle and dietary habits was obtained. Results. e median PTH values obtained with the 2 nd generation assay and the whole 3 rd generation assay were 20.26 pg/ml and 23.11 pg/ml, respectively. Bland-Altman method showed substantial concordance between the two PTH assays, although with an overestimation of the 3 rd generation method over the 2 nd generation method. ere was no correlation between 3 rd generation PTH and 25OHD3 and creatinine. Calcium was negatively correlated with PTH only when measured with 3 rd generation kit. Conclusions. On the basis of our data, obtained from healthy subjects, we can conclude that the reference range used by our laboratory was too narrow and was necessary to reestablish normal ranges according to our population. is is useful to avoid hyperparathyroidism misdiagnosis.

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Section: Discussionsupporting

confidence: 62%

PTH: Redefining Reference Ranges in a Healthy Population—The Role of Interfering Factors and the Type of Laboratory Assay

Censi

Iacobone

Simmini

et al. 2020

International Journal of Endocrinology

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“…The difference in PTH concentrations between the second- and third-generation assays has been studied among hemodialysis patients [202122]. PTH concentrations with the third-generation assay were lower than those with the second-generation assay at a magnitude of 40% to 50%, with a good correlation between them [822232425].…”

Section: Discussionmentioning

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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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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“…This is could be in part attributable to the accumulation of C-PTH 7-84 fragments in dialysis patients. 42 Whether using the third-generation PTH assay have greater clinical utility in patients with severe secondary or tertiary hyperparathyroidism remains to be studied.…”

Section: Third-generation Assaysmentioning

confidence: 99%

“…In a small study, Gannagé‐Yared et al found that, in hemodialysis patients, the correlation is strong when PTH values are relatively low and gets weaker as PTH levels rises. This is could be in part attributable to the accumulation of C‐PTH 7‐84 fragments in dialysis patients . Whether using the third‐generation PTH assay have greater clinical utility in patients with severe secondary or tertiary hyperparathyroidism remains to be studied.…”

Section: Introductionmentioning

confidence: 99%

PTH assays in dialysis patients: Practical considerations

Soliman

Hassan

Yaseen

et al. 2018

Seminars in Dialysis

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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.

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Comparison between a second and a third generation parathyroid hormone assay in hemodialysis patients

Cited by 13 publications

References 28 publications

PTH: Redefining Reference Ranges in a Healthy Population—The Role of Interfering Factors and the Type of Laboratory Assay

PTH: Redefining Reference Ranges in a Healthy Population—The Role of Interfering Factors and the Type of Laboratory Assay

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

PTH assays in dialysis patients: Practical considerations

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