Parathyroid Hormone Is More Stable in EDTA Plasma Than in Serum

Glendenning, Paul; Laffer, Leonie L. A.; Weber, H.; Musk, Alexander A.; Vasikaran, Samuel

doi:10.1093/clinchem/48.5.766

Cited by 35 publications

(19 citation statements)

References 4 publications

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“…Intact parathyroid hormone (PTH) was measured in EDTA plasma by immunochemiluminescence on the Immulite 2000 platform, ensuring complete sample filling of the collection vessel. 27,28 Interassay CV for intact PTH was 9% at 3AE2 pmol/l, 5AE6% at 30AE3 pmol/l and 5% at 104 pmol/l. 25OHD was measured by radioimmunoassay (RIA) using the DiaSorin RIA method with interassay CV of <10% at 14 and 33 nmol/l.…”

Section: Methodsmentioning

confidence: 90%

ORIGINAL ARTICLE: Association between 25‐hydroxyvitamin D, somatic muscle weakness and falls risk in end‐stage renal failure

Boudville

Inderjeeth

Elder

et al. 2010

Clinical Endocrinology

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Suboptimal levels of 25OHD in CKD-5D are associated with reduced quadriceps muscle strength and increased falls risk. 25OHD may be more important than the active renal metabolite 1,25(OH)(2)D for muscle strength with implications for vitamin D choice and goals of supplementation. Further investigation is required to examine effectiveness of calciferol supplementation on the incidence of falls in CKD-5D.

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Section: Methodsmentioning

confidence: 90%

ORIGINAL ARTICLE: Association between 25‐hydroxyvitamin D, somatic muscle weakness and falls risk in end‐stage renal failure

Boudville

Inderjeeth

Elder

et al. 2010

Clinical Endocrinology

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“…For intact PTH analysis, collection of whole blood into EDTA-containing sample tubes is recommended because serum values for PTH are significantly lower than EDTA plasma values using this method. 18 Twenty per cent of samples at baseline were misclassified according to the intact PTH assay reference limits when using serum samples. Unfortunately, EDTA plasma samples are also subject to problems.…”

Section: Recommendations For Australian Laboratoriesmentioning

confidence: 98%

Diagnosis of primary hyperparathyroidism: controversies, practical issues and the need for Australian guidelines

Glendenning¹

2003

Internal Medicine Journal

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Primary hyperparathyroidism (PHPT) is one of the most common endocrine disease processes, however the clinical presentation in 2003 is typically characterized by minimal signs or symptoms of hypercalcaemia or para-thyroid hormone (PTH) excess. Recent developments in imaging and management of PHPT have been published, however the area of biochemical investigation has been relatively neglected. A group of experts convened in April 2002 to consider whether changes were needed to the 1990 consensus guidelines which defined criteria for the diagnosis and management of asymptomatic PHPT. It is appropriate to review the revised recommendations, which have been disseminated by the panel and were recently published. Each of the laboratory -analytes used to establish the diagnosis of PHPT and exclude alternative diagnoses or complications will be considered in succession in this review: (i) calcium, (ii) intact PTH, (iii) urinary calcium and (iv) 25 hydroxy-vitamin D. Furthermore, critical appraisal of the new diagnostic criteria and their applicability to Australian laboratories will be addressed. Finally, limitations and problems associated with the measurement of each analyte will be reviewed.

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“…PTH concentrations measured in citrate plasma were lower with every assay method used than those observed in serum or EDTA plasma 20 . There have also been conflicting results regarding stability of PTH in plasma EDTA versus serum and this is also influenced by the time left at room temperature 21,22 …”

Section: Parathyroid Hormonementioning

confidence: 99%

“…Additional factors that give rise to differences among PTH assays involve the collection and storage of the specimen (pre‐analytic phase). PTH assay results can differ if samples are measured in plasma, serum or citrate and depending on whether samples are on ice, or allowed to sit at room temperature 20,21 . Joly et al.…”

Section: Parathyroid Hormonementioning

confidence: 99%

Review article: Chronic kidney disease‐mineral bone disorder: Have we got the assays right?

Zidehsarai

Moe

2009

Nephrology

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SUMMARY:Parathyroid hormone (PTH) and vitamin D [calcidiol or 25(OH)D] assays are used to diagnose chronic kidney disease-mineral bone disorder, and to guide and monitor interventions. Unfortunately, both assays have limitations. These limitations include analytical variability because of a lack of assay standardization, different calibrators used for each kit and differences in antibody specificity. For PTH assays, this leads to variability in the assessment of fragments and differences between results among kits from different manufacturers. For vitamin D, this leads to differences in the ability to detect D2 and D3 derivatives and differences among assays. For PTH, these problems are amplified by collection and handling differences and, for vitamin D, by diurnal and seasonal variation. Understanding these limitations should help clinicians to appropriately interpret results; attempts to develop universal standards to minimize these limitations may enhance the ability of these hormone measurements to predict underlying disease states. KEY WORDS: assay, chronic kidney disease, mineral bone disease, parathyroid hormone, vitamin D.To detect biochemical abnormalities, healthcare practitioners rely on clinical laboratory tests and specific thresholds or acceptable ranges for such tests are often recommended by clinical practice guidelines. Unfortunately, such guidelines seldom contain information about the performance characteristics for key tests, nor measurement methodology or standards. However, understanding the limitations of assays is critical for appropriate clinical interpretation. In the management of chronic kidney disease-mineral bone disorder (CKD-MSD), diagnostic and therapeutic decisions are often made on the basis of the hormonal assays parathyroid hormone (PTH) and vitamin D. This review will discuss the limitations of these assays and the impact such limitations may have on CKD patient care.

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Parathyroid Hormone Is More Stable in EDTA Plasma Than in Serum

Cited by 35 publications

References 4 publications

ORIGINAL ARTICLE: Association between 25‐hydroxyvitamin D, somatic muscle weakness and falls risk in end‐stage renal failure

ORIGINAL ARTICLE: Association between 25‐hydroxyvitamin D, somatic muscle weakness and falls risk in end‐stage renal failure

Diagnosis of primary hyperparathyroidism: controversies, practical issues and the need for Australian guidelines

Review article: Chronic kidney disease‐mineral bone disorder: Have we got the assays right?

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