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

Wójtowicz, Magdalena; Piechota, Wiesław; Wańkowicz, Z; Smoszna, Jerzy; Niemczyk, Stanisław

doi:10.12659/msm.928301

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…Similarly, Hecking et al ( 22 ) compared two-generation Roche PTH assays among haemodialysis patients in Vienna and found that such assays had a strong positive correlation and that the bio-PTH level was roughly two-thirds lower than the iPTH level. In a study among CKD patients in different stages ( 23 ), the concentration of bio-PTH in dialysed patients was more than 40% lower than that of iPTH. This percentage is higher than in our study, in which the bio-PTH concentration was 30% lower than the iPTH concentration among dialysed patients.…”

Section: Discussionmentioning

confidence: 98%

Agreement of Parathyroid Hormone Status Measured by Intact and Biointact Parathyroid Hormone Assays among Chronic Kidney Disease Patients and Its Correlation with Bone Turnover Parameters

Hashim¹,

Ismail²,

Soh³

et al. 2023

MJMS

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Background: This study aimed to determine the agreement between intact parathyroid hormone (iPTH) and biointact parathyroid hormone (bio-PTH) assays and to correlate them with bone markers. Methods: This cross-sectional study included 180 patients with chronic kidney disease (CKD) stages 3b, 4 and 5D. We measured their iPTH, bio-PTH, 25-hydroxyvitaminD (25(OH)D), C-terminal telopeptide collagen (CTX), procollagen 1 intact N-terminal propeptide (P1NP), calcium, phosphate and alkaline phosphatase (ALP). Results: Higher iPTH than bio-PTH concentrations were seen in CKD stages 3b, 4 and 5D (58[62] versus 55[67] pg/mL, 94[85] versus 85[76] pg/mL and 378[481] versus 252[280] pg/mL, respectively). Both PTH assays showed good agreement among all the subjects, with an intraclass correlation coefficient of 0.832 (P-value < 0.001). The Passing-Bablok showed that the equation for the bio-PTH was PTH = 0.64 iPTH + 15.80, with r = 0.99. The Bland-Altman plots showed increased bias with an increasing PTH concentration. Both PTH assays showed a high positive correlation with CTX and P1NP, a moderate correlation with phosphate, a low correlation with ALP and calcium, and a negligible correlation with phosphate and 25(OH)D. Conclusion: The iPTH and bio-PTH assays were in agreement, but their bias increased with the PTH concentration. The unacceptable large bias indicates that the two assays cannot be used interchangeably. They had a variable correlation with the bone parameters.

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Section: Discussionmentioning

confidence: 98%

Agreement of Parathyroid Hormone Status Measured by Intact and Biointact Parathyroid Hormone Assays among Chronic Kidney Disease Patients and Its Correlation with Bone Turnover Parameters

Hashim¹,

Ismail²,

Soh³

et al. 2023

MJMS

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“…Previous studies showed that PTH fragments of various lengths were mostly from the liver, whereas a part of them was secreted directly by the parathyroid gland [ 1 , 2 ], and their clearance relied on renal function. A recent study involving predialysis patients with CKD showed that differences between iPTH and PTH(1–84) increased along with the degree of renal function impairment which was found in about 30% of these patients [ 22 ]. Though eGFR levels were different between the groups, all patients enrolled in the study showed normal renal functions, which would be a reason for the similar ∆PTH% and the 3 rd /2 nd ratio between the PHP1 and PHPT groups.…”

Section: Discussionmentioning

confidence: 99%

Full-length versus intact PTH concentrations in pseudohypoparathyroidism type 1 and primary hyperparathyroidism: clinical evaluation of immunoassays in individuals from China

Yang

Song

et al. 2022

Endocrine

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Purpose The application of the third-generation parathyroid hormone (PTH) assay [PTH(1–84) assay] for evaluating PTH levels in patients with pseudohypoparathyroidism type-1 (PHP1) is less popular than the second-generation assay. Therefore, we aimed at examining the conformity between the PTH(1–84) assay and the intact PTH (iPTH) assay, specifically examining their performance in individuals with PHP1 versus individuals with primary hyperparathyroidism (PHPT), compared to healthy controls. Methods PTH(1–84) and iPTH assay were performed in patients with PHP1, patients with PHPT, and healthy volunteers. ∆PTH%, PTH(1–84)/iPTH (3 rd /2 nd ratio), iPTH/upper limit of normal (ULN), and PTH (1–84)/ULN of each group were calculated for comparison. Linear regression, Kappa conformity test, and Bland–Altman analysis of ∆PTH/mean of iPTH and PTH(1–84) (percent bias) plotted against the mean of iPTH and PTH(1–84) were performed to determine the conformance of PTH(1–84) assay with iPTH assay. Results A total of 54 patients with PHP1, 127 patients with PHPT, and 65 healthy volunteers were enrolled in this study. All the three groups showed strong linear relationship between iPTH and PTH (1–84) ( r 2 = 0.9661, 0.7733, and 0.9575, respectively). No significant differences were noted in 3 rd /2 nd ratio (median 0.76 vs. 0.72) between the PHP1 and PHPT groups ( p > 0.05). Conformity examination showed the Kappa value was 0.778 and 0.395 for PHP1 and PHPT groups respectively. No difference in the Kappa values was found between PHP1A and PHP1B subgroups. Bland–Altman plot demonstrated that the proportion of data points that were plotted within mean ± 1.96 SD in PHP1, PHPT and normal control groups were 96.3%, 93.7%, and 98.5%, respectively. The mean percent bias of the three groups were 26.1%, 31.2%, and 17.0%, respectively. The range of mean ± 1.96 SD of percent bias of the three groups were 2.2%–50.0%, −14.3%–76.6%, and 6.7%–27.2%, respectively. Conclusion Although iPTH and PTH(1–84) values were both lower in the present PHP1 cohort than in the PHPT cohort, there appear to be differences in the relative agreement between both immunoassays, and in the relationship between the two values, especially in comparison to healthy controls. Whether these differences are due to differential accumulation of C-terminal fragments or other factors requires further study.

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Serum iPTH range in a reference population: From an integrated approach to vitamin D prevalence impact evaluation

Minieri

Leoni²,

Bellincampi

et al. 2021

Clinica Chimica Acta

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

Cited by 3 publications

References 10 publications

Agreement of Parathyroid Hormone Status Measured by Intact and Biointact Parathyroid Hormone Assays among Chronic Kidney Disease Patients and Its Correlation with Bone Turnover Parameters

Agreement of Parathyroid Hormone Status Measured by Intact and Biointact Parathyroid Hormone Assays among Chronic Kidney Disease Patients and Its Correlation with Bone Turnover Parameters

Full-length versus intact PTH concentrations in pseudohypoparathyroidism type 1 and primary hyperparathyroidism: clinical evaluation of immunoassays in individuals from China

Serum iPTH range in a reference population: From an integrated approach to vitamin D prevalence impact evaluation

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