TY  - JOUR
A1  - Tepel, Martin
A1  - Armbruster, Franz Paul
A1  - Groen, Hans Juergen
A1  - Scholze, Alexandra
A1  - Reichetzeder, Christoph
A1  - Roth, Heinz Jürgen
A1  - Hocher, Berthold
T1  - Nonoxidized, biologically active parathyroid hormone determines mortality in hemodialysis patients
T2  - The journal of clinical endocrinology & metabolism
N2  - Background: It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity.
 Methods: In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system.
 Results: Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (chi(2), 14.3; P = 0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas higher n-oxPTH reduced the odds for death. Another model analyzing a subgroup of patients with intact PTH (iPTH) concentrations at baseline above the upper normal range of the iPTH assay (70 ng/L) revealed that mortality in this subgroup was associated with oxidized PTH but not with n-oxPTH levels.
 Conclusions: The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality.
Y1  - 2013
UR  - https://publishup.uni-potsdam.de/frontdoor/index/index/docId/34540
SN  - 0021-972X
SN  - 1945-7197
VL  - 98
IS  - 12
SP  - 4744
EP  - 4751
PB  - Endocrine Society
CY  - Chevy Chase
ER  -