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

Einbinder, Yael; Benchetrit, Sydney; Golan, Eliezer; Zitman‐Gal, Tali

doi:10.3343/alm.2017.37.5.381

Cited by 14 publications

(9 citation statements)

References 36 publications

(50 reference statements)

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“…The study also suggested that the PTH (1–84) assay may better reflect mineral disorders, probably with more accurate assessment of bone turnover in CKD, but additional confirmatory studies are needed, including bone biopsy [ 16 ]. Many correlations found in our study confirm the pathophysiological relationship between PTH and eGFR, calcium, and inorganic phosphate concentrations in the serum of patients with CKD that have been demonstrated by other authors [ 21 , 22 ].…”

Section: Discussionsupporting

confidence: 91%

Comparison of Second- and Third-Generation Parathyroid Hormone Test Results in Patients with Chronic Kidney Disease

et al. 2020

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Section: Discussionsupporting

confidence: 91%

Comparison of Second- and Third-Generation Parathyroid Hormone Test Results in Patients with Chronic Kidney Disease

et al. 2020

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“…C-PTH fragments are cleared from the circulation through the kidneys, as (1-84) PTH itself, thus accumulating in the blood of patients suffering from CKD [4]. Previous studies have indicated the different levels of iPTH and (1-84)PTH existed both in pre-dialysis [26] and dialysis patients [25,27,28]. It was reported that in people with normal renal function, (7-84)PTH accounted for 20 % of iPTH and for about 50 % in ▶Fig.…”

Section: Discussionmentioning

confidence: 99%

Effects of Parathyroidectomy on Plasma iPTH and (1–84) PTH Levels in Patients with Stage 5 Chronic Kidney Disease

et al. 2018

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Currently, the second-generation intact parathyroid hormone (iPTH) assay is commonly used for measuring PTH levels. The iPTH assay detects both full-length (1-84)PTH and (7-84)PTH fragments, which have antagonistic effects on (1-84)PTH in bones and kidneys. The third-generation PTH assay is specific for (1-84)PTH. This study examined the features of different PTH fragments in stage 5 chronic kidney disease (CKD) and the effects of parathyroidectomy (PTX) on the above markers in severe secondary hyperparathyroidism (SHPT) patients. The cross-sectional study included 262 stage 5 CKD patients and 90 controls. A prospective follow-up study was then conducted in 34 PTX patients. Second- and third-generation assays were used to measure plasma iPTH and (1-84)PTH levels, respectively. Circulating (7-84)PTH levels were calculated by subtracting the (1-84)PTH value from the iPTH value. Different plasma PTH fragments were higher, and (1-84)PTH/iPTH was lower in CKD patients than in controls. Plasma (1-84)PTH and (7-84)PTH concentrations increased as iPTH levels increased, and (7-84)PTH increased more evidently. Plasma iPTH, (1-84)PTH and (7-84)PTH levels were 1530.5 (885.0-2111.5) pg/ml, 683.1 (431.4-1018.0) pg/ml, and 739.3 (452.6-1261.0) pg/ml, respectively, in PTX patients. Plasma iPTH, (1-84)PTH and (7-84)PTH concentrations decreased considerably, and the (1-84)PTH/iPTH ratio increased after PTX (median follow-up interval: 10.9 months). Stage 5 CKD patients had higher plasma levels of different PTH fragments, and lower (1-84)PTH/iPTH ratio. PTX could significantly reverse these abnormalities in severe SHPT patients. The iPTH assay overestimated the function of the parathyroid glands; thus, the third-generation PTH assay is likely better for the management of CKD patients.

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“…Thus, KDIGO recommends using the trend of PTH to guide treatment [4]. In a study performed by Einbinder et al [21] in 2017, iPTH and biointact PTH kits were compared in patients with nondialysis CKD and as expected, the biointact PTH results were lower. Although PTH measurement with biointact PTH is effective, since it targets the first few amino acids at the N-terminal end, it is not yet widely used, either in our country or globally.…”

Section: Discussionmentioning

confidence: 91%

Evaluation of analytical performance of two iPTH immunoassay methods in hemodialysis patients

Yis¹

2020

Int J Med Biochem

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Evaluation of analytical performance of two iPTH immunoassay methods in hemodialysis patients P arathormone (PTH) is a peptide synthesized as an 115-amino acid preprohormone in the parathyroid gland in response to a decreased serum calcium level and is used as a marker for chronic kidney disease mineral and bone disorder (CKD-MBD) [1]. PTH is synthesized as a preprohormone as a linear protein of 84 amino acids and the remainder is known as intact PTH (iPTH). iPTH rapidly breaks down in the blood to yield N-terminal and C-terminal fragments of 34-amino acid. PTH can be present in the blood in 3 forms: iPTH, N-terminal, and C-terminal. The iPTH and N-terminal forms are biologically active, but have a short halflife. C-terminal fragments, however, are an inactive form and have a longer half-life than iPTH. PTH is metabolized mainly in the kidneys and the liver. The kidneys play an important role in the excretion of inactive fragments [2]. Eighty percent of blood PTH in normal patients and approximately 95% of blood PTH in chronic kidney disease (CKD) patients is in the C-terminal form. Renal excretion of C-terminal fragments causes an accumulation of the C-terminal form in the blood in CKD patients [3]. The measurement of the accumulated Objectives: Renal excretion of parathormone (PTH) C-terminal fragments can cause an accumulation of the C-terminal form in the blood in chronic kidney disease patients. Thus, the measurement of the active form of PTH has become important. This study was designed to compare the Architect iPTH test measured using the Architect i2000SR System (Abbott Laboratories, Lake Bluff, IL, USA) and the Beckman iPTH test measured using the Beckman Coulter Dxi 800 (Beckman Coulter, Brea, CA, USA), which are 2 immunoassay systems commonly used in routine laboratory analyses, and to evaluate the analytical performance in hemodialysis patients. Methods: The immunoassays were assessed for accuracy, precision, limit of blank (LoB), limit of detection (LoD), and limit of quantification (LoQ). Results: A total of 86 samples were run on both systems and the correlation between the methods was evaluated. The i2000SR and Dxi 800 assays demonstrated good performance in terms of precision, accuracy, LoB, LoD, and LoQ. Intraclass correlation coefficient analysis revealed a difference of 0.912 (0.489-0.968) with a y=2.58+1.53x equation. Conclusion: It was confirmed that these analyzers widely used for iPTH measurement operate at an acceptable level of analytical performance. It was observed that the measurements obtained from both analyzers were consistent, but the Abbott Architect i2000SR provided higher results than the Beckman Coulter Dxi800. For consistency, is suggested that patient follow-up should be performed using the same kits, the same analysis system, and in the same laboratory.

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

Cited by 14 publications

References 36 publications

Comparison of Second- and Third-Generation Parathyroid Hormone Test Results in Patients with Chronic Kidney Disease

Comparison of Second- and Third-Generation Parathyroid Hormone Test Results in Patients with Chronic Kidney Disease

Effects of Parathyroidectomy on Plasma iPTH and (1–84) PTH Levels in Patients with Stage 5 Chronic Kidney Disease

Evaluation of analytical performance of two iPTH immunoassay methods in hemodialysis patients

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