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Differences between 2nd and 3rd generation seric parathormone determination methods on mortality in haemodialysis
Laura Rodríguez-Osorio1, Concepción de la Piedra2, Mercedes Rubert2
1Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, España; Instituto de Investigación Sanitaria, Fundación Jiménez Díaz (IIS-FJD), Madrid, España.
Summary
This study found no mortality prediction advantage of bio-intact parathyroid hormone (PTHbio) over intact parathyroid hormone (iPTH) in dialysis patients. PTHbio
Area of Science:
- Nephrology
- Endocrinology
- Clinical Chemistry
Background:
- Parathormone (PTH) is crucial for mineral metabolism and a uremic toxin linked to cardiovascular issues in dialysis patients.
- Two assays exist: 2nd generation intact PTH (iPTH) and 3rd generation bio-PTH (PTHbio).
Purpose of the Study:
- To compare mortality prediction between iPTH and PTHbio assays in dialysis patients.
- To investigate the prognostic role of the PTHbio/iPTH ratio.
Main Methods:
- 145 hemodialysis patients were monitored for 2 years.
- Baseline and annual laboratory tests were conducted.
Main Results:
- No significant correlation was found between PTH levels (iPTH, PTHbio, or their ratio) and mortality.
- Both assays correlated well with each other and other mineral metabolism markers.
- Extreme baseline PTH values were associated with higher mortality, showing a J-curve survival pattern with iPTH intervals.
- PTHbio did not offer superior prognostic accuracy for mortality compared to iPTH.
Conclusions:
- Bio-PTH (PTHbio) offers no discernible advantage over intact PTH (iPTH) for predicting mortality in dialysis patients.
- The established normal limits for PTHbio require reevaluation due to inconsistent relationships with iPTH.
- Uncertainty in PTHbio normal limits impacts its prognostic utility.