geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Intact PTH combined with the PTH ratio for diagnosis of bone turnover in dialysis patients: a diagnostic test study


, : Intact PTH combined with the PTH ratio for diagnosis of bone turnover in dialysis patients: a diagnostic test study. American Journal of Kidney Diseases 55(5): 897-906

Determination of parathyroid hormone (PTH) level is the most commonly used surrogate marker for bone turnover in patients with stage 5 chronic kidney disease on dialysis therapy (CKD-5D). The objective of this study is to evaluate the predictive value of various PTH measurements for identifying low or high bone turnover rate. Diagnostic test study. 141 patients with CKD-5D from 15 US hemodialysis centers. Intact PTH, PTH 1-84, and PTH ratio (ratio of level of PTH 1-84 to level of large carboxy-terminal PTH fragments). Bone turnover determined using bone histomorphometry. Demographic and treatment-related factors, serum calcium and phosphorus. Patients presented histologically with a broad range of bone turnover abnormalities. In white patients with CKD-5D (n = 70), PTH ratio <1.0 added to intact PTH level <420 pg/mL increased the positive predictive value for low bone turnover from 74% to 90%. In black patients (n = 71), adding PTH ratio <1.2 to intact PTH level <340 pg/mL increased the positive predictive value for low bone turnover from 48% to 90%. Adding PTH ratio >1.6 to intact PTH level of 340-790 pg/mL increased the positive predictive value for high bone turnover from 56% to 71%. Because the research protocol called for carefully controlled blood specimen handling, blood drawing and routine specimen handling might be less stringent in clinical practice. By limiting study participation to black and white patients with CKD-5D, we cannot comment on the roles of intact PTH, PTH 1-84, and PTH ratio in other racial/ethnic groups. In black patients with CKD-5D, the addition of PTH ratio to intact PTH measurements is helpful for diagnosing low and high bone turnover. In white patients with CKD-5D, it aids in the diagnosis of low bone turnover.

US$19.90

PMID: 20347512

DOI: 10.1053/j.ajkd.2009.12.041


Other references

Silver P.J.; Harris A.L.; Fort D.J.; Perrone M.H.; Evans D.B., 1987: Effects of the cardiotonic vasodilator agents amrinone and milrinone on phosphodiesterase pde isozymes and contractile force in guinea pig cardiac and vascular tissue. Federation Proceedings 46(3): 373

Essler; Korepin; Schoutens, 1992: New exactly solvable model of strongly correlated electrons motivated by high-Tc superconductivity. Physical Review Letters 68(19): 2960-2963

Wright, H.T.; Nurse, K.C.; Goldstein, D.J., 1981: Nalidixic acid, oxolinic acid, and novobiocin inhibit yeast glycyl- and leucyl-transfer RNA synthetases. Nalidixic acid and novobiocin inhibit the aminoacylation and pyrophosphate exchange activities of glycyl- and leucyl-transfer RNA synthetases from bakers' yeast. Similar types of inhibition are observed for both enzymes, suggesting similar me...

Van Den Brink, J.S.; Hulsebosch, R.J.; Gast, P.; Hore, P.J.; Hoff, A.J., 1994: Q-A binding in reaction centers of the photosynthetic purple bacterium Rhodobacter sphaeroides R26 investigated with electron spin polarization spectroscopy. The relation between quinone (QA) binding and electron transport in reaction centers (RCs) of photosynthetic purple bacteria is investigated, using electron spin polarization (ESP) X-band (9 GHz) EPR as a tool to probe for structural changes resul...

Williamson, E.H.; Navarro, E.Z.; Zwemer, J.D., 1993: A comparison of electromyographic activity between anterior repositioning splint therapy and a centric relation splint. The purpose of this study was to compare the electromyographic activity of masticatory muscles (temporal and masseter) with the use of an anterior repositioning splint and a centric relation superior repositioning splint. Twenty-six consecutive pa...

E.F.McBride, (2), T.N.Diggs, (2),, 1991: Compaction of Wilcox and Carrizo sandstones (Paleocene-Eocene) to 4420 M, Texas Gulf Coast. SEPM Journal of Sedimentary Research Vol. 61: 736-740

Pott, R., 1992: History of the forests of the Westphalian mountains under the influence of man. The postglacial history of the woodlands is described on the basis of pollen analyses, and then an account is given of the historical utilization of the forest by man. Various traditional systems of forest pasture, coppice and lopping systems, and...

Kalaydzhiev S., 1969: Structure of the Venetsa copper deposit, western Balkans. Izvestiya na Geologicheski Institut, Seriya Rudni i Nerudni Polezni Izkopaemi 18: 73-91

Lührmann, R.; Will, C.L., 1995: Through the glass lightly. Science 267(5204): 1616-1617

Gerstel, D.U.; Burns, J.A.; Burk, L.G., 1974: Meiosis in F1 hybrids between haploid-derived diploids and their parents. Meiotic studies in the F1s between haploid-derived diploids obtained by chromosome doubling of haploids derived from anther culture and the original diploids used for anther culture revealed no heterozygosity for chromosomal rearrangements. Some m...