Authors: Yudo Tanno¹; Keitaro Yokoyama¹; Masaaki Nakayama¹; Akihiko Katoh¹; Hiroyasu Yamamoto¹; Yoshiko Iwasaki²; Tom Cantor³; Masafumi Fukagawa⁴; Takashi Shigematsu¹; Tatsuo Hosoya¹

Source: Nephrology Dialysis Transplantation, Volume 18, Supplement 1, March 2003 , pp. iii97-iii98(2)

Publisher: Oxford University Press

Abstract:

The common intact parathyroid hormone (i-PTH) assay detects not only PTH (1–84) but also the PTH (7–84) fragment. Recently, it was reported that the PTH (7–84) fragment is an antagonist to the biological action of PTH (1–84). It was also reported that the accumulation of the PTH (7–84) fragment plays a role in skeletal resistance in haemodialysis (HD) patients. However, the role of accumulation of the PTH (7–84) fragment in continuous ambulatory peritoneal dialysis (CAPD) patients, with a different clearance rate from that of HD patients, is still unclear. Therefore, we have measured only the active form of PTH (1–84) using a new method of whole PTH (w-PTH) assay in 20 CAPD patients (15 male and five female; mean age 51.0±13.0 years). The mean w-PTH value was 88.5 ±14.2 pg/ml in CAPD patients, which was 42.1% of i-PTH (152.6±23.6 pg/ml). The approximate value of w-PTH was calculated using the following formula (w-PTH=0.58×iPTH–0.4, R²=0.94). PTH (7–84) fragment was calculated by the formula i-PTH–w-PTH. The PTH (7–84) fragment/w-PTH ratio as an index of skeletal resistance, and serum alkaline phosphatase activity as an osteoblastic marker were negatively correlated (P=0.02). From these results, we concluded that the i-PTH level as calculated using the common assay method might lead to an overestimation of parathyroid function and bone turnover in CAPD patients similarly to HD patients. The w-PTH assay may be useful for more precise evaluation of PTH activity in end-stage renal disease patients.

Keywords: CAPD; end-stage renal disease; low turnover bone disease; PTH (7–84)/PTH (1–84) ratio; skeletal resistance; whole PTH assay

Document Type: Research article

DOI: http://dx.doi.org/10.1093/ndt/gfg1025

Affiliations: 1: The Division of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, 2: Tokyo Teisin Hospital, Tokyo, 3: Scantibodies Laboratory Santee, USA 4: Division of Metabolic Disease, Kobe University School of Medicine, Hyogo, Japan and

Publication date: 2003-03-01

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• Nephrology Dialysis Transplantation is one of the world's leading journals devoted to original clinical and laboratory research in nephrology, dialysis and transplantation. Published monthly, the journal provides an essential resource for researchers and clinicians throughout the world.

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