Why Current PTH Assays Mislead Clinical Decision Making in Patients with Secondary Hyperparathyroidism
- Preclinical studies in cell culture systems as well as in whole animal chronic kidney disease (CKD) models showed that parathyroid hormone (PTH), oxidized at the 2 methionine residues (positions 8 and 18), caused a loss of function. This was so far not considered in the development of PTH assays used in current clinical practice. Patients with advanced CKD are subject to oxidative stress, and plasma proteins (including PTH) are targets for oxidants. In patients with CKD, a considerable but variable fraction (about 70 to 90%) of measured PTH appears to be oxidized. Oxidized PTH (oxPTH) does not interact with the PTH receptor resulting in loss of biological activity. Currently used intact PTH (iPTH) assays detect both oxidized and non-oxPTH (n-oxPTH). Clinical studies demonstrated that bioactive, n-oxPTH, but not iPTH nor oxPTH, is associated with mortality in CKD patients.
| Author details: | Berthold HocherORCiDGND, Lianghong YinGND |
|---|---|
| DOI: | https://doi.org/10.1159/000455289 |
| ISSN: | 1660-8151 |
| ISSN: | 2235-3186 |
| ISSN: | 0028-2766 |
| Pubmed ID: | https://pubmed.ncbi.nlm.nih.gov/28183082 |
| Title of parent work (English): | Nephron |
| Publisher: | Karger |
| Place of publishing: | Basel |
| Publication type: | Other |
| Language: | English |
| Date of first publication: | 2017/02/10 |
| Publication year: | 2017 |
| Release date: | 2022/11/18 |
| Tag: | Dialysis patients; Mortality; Serum intact-parathyroid hormone level |
| Volume: | 136 |
| Issue: | 2 |
| Number of pages: | 6 |
| First page: | 137 |
| Last Page: | 142 |
| Organizational units: | Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften |
| DDC classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
| Peer review: | Referiert |
