Switching between parathormone (PTH) assays: the impact on the diagnosis of renal osteodystrophy
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Gabriella Bekő
, Henriett Butz , Klára Berta , András Tislér , Ferenc Olajos , Barna Vásárhelyi und Attila Patócs
Abstract
Background: Clinical guidelines for decision-making in chronic kidney disease (CKD) consider parathormone (PTH) levels. The measured PTH values differ if novel full length PTH(1-84) assays are used instead of earlier intact iPTH assays. In this study we analyzed how the classification of CKD patients alters when iPTH assays are switched to PTH(1-84) assays.
Methods: Plasma samples were collected prior to dialysis sessions from 110 consecutive CKD patients on maintenance hemodialysis. PTH levels were determined with iPTH assays (Elecsys, Architect and DiaSorin Liaison N-tact) and PTH(1-84) assays (Elecsys and Liaison). Using KDIGO guidelines patients were classified as being below, above and in the recommended target range (RTR) of PTH. The results of classification with different assays were evaluated and, a novel calculation method of RTR was implemented.
Results: The prevalence of patients with PTH in RTR is comparable with each assay, but the individual patients differed. PTH(1-84) Elecsys and Liaison assays classified more patients as being below RTR than iPTH Elecsys and Architect but not Liaison N-tact assay (27.3%, 22.7% vs. 41%, 31.8%, and 36.4%, respectively). In turn, PTH(1-84) Elecsys and Liaison assays identified less CKD patients with PTH above the RTR than iPTH except N-tact assays (6.4%, 10% vs. 16.3%, 19%, and 6.3%, respectively). Using our calculation method, our discrimination values for PTH(1-84) assays to achieve classification identical to that with iPTH Elecsys were lower than those recommended by the manufacturer.
Conclusions: Current guidelines for the treatment of secondary hyperparathyroidism in CKD should consider the type of assays used for PTH measurement. Each laboratory should assess its own RTR for PTH tests to achieve comparable classification. The presented calculation is simple, it mimics an everyday situation, switching from one assay to another one, and provides useful RTR values for PTH tests.
This work was granted by TÁMOP 4.2.2.B-10/1. Attila Patocs is a recipient of the Janos Bolyai fellowship.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
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©2013 by Walter de Gruyter Berlin Boston
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Artikel in diesem Heft
- Letters to the Editor
- Evaluation of a novel room temperature RNA storage tube for use in a real-time quantitative PCR assay
- Evaluation of the Universal Master Mix (STAT-NAT DNA-Mix) for reliable molecular testing
- HbA1c: performance of the Sebia Capillarys 2 Flex Piercing
- A case of monoclonal gammopathy of undetermined significance (MGUS): type IgD-lambda
- Evidence-based use of serum protein electrophoresis in laboratory medicine
- Plasma volume shifts during multiday racing
- Structured handoff at shift change in a clinical laboratory increases patient safety
- Instrument-dependent interference of Howell-Jolly bodies in reticulocyte enumeration
- Reply to Gore et al.: Plasma volume shift during multiday racing
- Recommendations for appropriate serum electrophoresis requests: the Italian approach
- Masthead
- Masthead
- Editorials
- Biomarkers for sepsis: an unfinished journey
- Laboratory demand management of repetitive testing – time for harmonisation and an evidenced based approach
- Reviews
- Non-invasive prenatal diagnostics of aneuploidy using next-generation DNA sequencing technologies, and clinical considerations
- The diagnostic utility of brain natriuretic peptide in heart failure patients presenting with acute dyspnea: a meta-analysis
- Opinion Paper
- Opinion paper on innovative approach of biomarkers for infectious diseases and sepsis management in the emergency department
- Genetics and Molecular Diagnostics
- Microarray with LNA-probes for genotyping of polymorphic variants of Gilbert’s syndrome gene UGT1A1(TA)n
- Selection of the optimal manual method of cell free fetal DNA isolation from maternal plasma
- A multiplex assay to rapidly exclude HLA-DQ2.5 and HLA-DQ8 expression in patients at risk for celiac disease
- Low cost biosensor-based molecular differential diagnosis of α-thalassemia (Southeast Asia deletion)
- General Clinical Chemistry and Laboratory Medicine
- Managing laboratory test ordering through test frequency filtering
- Critical review of laboratory investigations in clinical practice guidelines: proposals for the description of investigation
- Long-term stability of laboratory tests and practical implications for quality management
- Coffee consumption, serum γ-glutamyltransferase, and glucose tolerance status in middle-aged Japanese men
- Biological variation and prognosis usefulness of new biomarkers in liver transplantation
- Switching between parathormone (PTH) assays: the impact on the diagnosis of renal osteodystrophy
- A comparison between two different in vitro basophil activation tests for gluten- and cow’s milk protein sensitivity in irritable bowel syndrome (IBS)-like patients
- A proficiency testing program of hemoglobin analysis in prevention and control of severe hemoglobinopathies in Thailand
- Advancing haemostasis automation – successful implementation of robotic centrifugation and sample processing in a tertiary service hospital
- ADAM12s and PP13 as first trimester screening markers for adverse pregnancy outcome
- Analysis of serous body fluids using the CELL-DYN Sapphire hematology analyzer
- Cancer Diagnostics
- Association and prognostic value of serum inflammation markers in patients with leukoplakia and oral cavity cancer
- Do laboratories follow heart failure recommendations and guidelines and did we improve? The CARdiac MArker Guideline Uptake in Europe (CARMAGUE)
- Cardiovascular Diseases
- Additional diagnostic and prognostic value of copeptin ultra-sensitive for diagnosis of non-ST-elevation myocardial infarction in older patients presenting to the emergency department1)
- Moderate elevations of high-sensitivity cardiac troponin I and B-type natriuretic peptide in chronic hemodialysis patients are associated with mortality