Skip to main content
SpringerLink
Log in

Differences between ‘intact’ PTH and 1–84 PTH assays in chronic renal failure and dialysis

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

‘Intact’ parathyroid hormone (iPTH) assays overestimate actual PTH as they cross-react with non (1–84) PTH fragments (C-PTH) that accumulate in renal failure. New assays that measure just 1–84 PTH (CAP-PTH) are now available. It has been suggested that there is a linear relationship between the two assays; however, increased C-PTH levels are found as glomerular filtration rate (GFR) declines and in patients on dialysis. We investigated the relationship between iPTH and CAP-PTH in children with chronic renal failure (CRF) managed conservatively and on dialysis. We investigated 241 children, 156 with a GFR <60 ml/min per 1.73 m2 managed conservatively, 49 post renal transplant (and GFR <60 ml/min per 1.73 m2) and 36 on dialysis, by measuring PTH levels by iPTH and CAP-PTH assays. Multiple regression analysis comparing differences between PTH levels in each patient group was performed. Correlation slopes between iPTH and CAP-PTH assays differed between CRF and dialysis patients (P=0.001). These assays perform differently in CRF and dialysis patient groups. Studies investigating the correlation between newer assays and bone histology are required to determine whether these more-specific PTH assays are superior surrogate markers of bone turnover.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Goodman WG, Salusky IB, Juppner H (2002) New lessons from old assays: parathyroid hormone (PTH), its receptors, and the potential biological relevance of PTH fragments. Nephrol Dial Transplant 17:1731–1736

    Article  Google Scholar 

  2. John MR, Goodman WG, Gao P, Cantor TL, Salusky IB, Juppner H (1999) A novel immunoradiometric assay detects full-length human PTH but not amino-terminally truncated fragments: implications for PTH measurements in renal failure. J Clin Endocrinol Metab 84:4287–4290

    Article  CAS  PubMed  Google Scholar 

  3. Tanno Y, Yokoyama K, Nakayama M, Katoh A, Yamamoto H, Iwasaki Y, Cantor T, Fukagawa M, Shigematsu T, Hosoya T (2003) IRMA (whole PTH) is a more useful assay for the effect of PTH on bone than the Allegro intact PTH assay in CAPD patients with low bone turnover marker. Nephrol Dial Transplant 18 [Suppl 3]:97–98

  4. Reichel H, Esser A, Roth HJ, Schmidt-Gayk H (2003) Influence of PTH assay methodology on differential diagnosis of renal bone disease. Nephrol Dial Transplant 18:759–768

    Article  Google Scholar 

  5. Goodman WG, Juppner H, Salusky IB, Sherrard DJ (2003) Parathyroid hormone (PTH), PTH-derived peptides, and new PTH assays in renal osteodystrophy. Kidney Int 63:1–11

    Article  Google Scholar 

  6. Brossard JH, Lepage R, Cardinal H, Roy L, Rousseau L, Dorais C, D’Amour P (2000) Influence of glomerular filtration rate on non-(1–84) parathyroid hormone (PTH) detected by intact PTH assays. Clin Chem 46:697–703

    CAS  PubMed  Google Scholar 

  7. Waller S, Reynolds A, Ridout D, Cantor T, Gao P, Rees L (2003) Parathyroid hormone and its fragments in children with chronic renal failure. Pediatr Nephrol 18:1242–1248

    Article  Google Scholar 

  8. Salusky IB, Ramirez JA, Oppenheim W, Gales B, Segre GV, Goodman WG (1994) Biochemical markers of renal osteodystrophy in pediatric patients undergoing CAPD/CCPD. Kidney Int 45:253–258

    CAS  PubMed  Google Scholar 

  9. Godber IM, Parker CR, Lawson N, Hitch T, Porter CJ, Roe SD, Cassidy MJ, Hosking DJ (2002) Comparison of intact and ‘whole molecule’ parathyroid hormone assays in patients with histologically confirmed post-renal transplant osteodystrophy. Ann Clin Biochem 39:314–317

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from the National Kidney Research Fund (R 18/2/2001), Renal Care and Research Association and the Special Trustees of Great Ormond Street Hospital.

Author information

Authors and Affiliations

  1. Department of Nephro-Urology, Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London, UK

    Simon Waller & Lesley Rees

  2. Department of Paediatric Epidemiology and Biostatistics Unit, Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London, UK

    Deborah Ridout

  3. Scantibodies Laboratories, Santee, California, USA

    Tom Cantor

  4. Renal Offices, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1 N 3EJ, UK

    Simon Waller

Authors
  1. Simon Waller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deborah Ridout
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tom Cantor
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lesley Rees
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simon Waller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waller, S., Ridout, D., Cantor, T. et al. Differences between ‘intact’ PTH and 1–84 PTH assays in chronic renal failure and dialysis. Pediatr Nephrol 20, 197–199 (2005). https://doi.org/10.1007/s00467-004-1735-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-004-1735-2

Keywords

Search

Navigation