Why Current PTH Assays Mislead Clinical Decision Making in Patients with Secondary Hyperparathyroidism

被引：19

作者：

Hocher, Berthold ^{[1
,2
,3
,4
]}

Yin, Lianghong ^{[4
]}

机构：

[1] Univ Potsdam, Inst Nutr Sci, DE-14558 Potsdam, Germany

[2] Inst Lab Med Berlin, Berlin, Germany

[3] Jinan Univ, Affiliated Hosp 1, Sch Med, Dept Embryol, Guangzhou, Guangdong, Peoples R China

[4] Jinan Univ, Affiliated Hosp 1, Guangzhou Overseas Chinese Hosp, Dept Embryol, Guangzhou, Guangdong, Peoples R China

来源：

NEPHRON | 2017年 / 136卷 / 02期

关键词：

Serum intact-parathyroid hormone level; Dialysis patients; Mortality; HUMAN PARATHYROID-HORMONE; CARDIOVASCULAR-DISEASE; VITAMIN-D; PERIPHERAL METABOLISM; HEMODIALYSIS-PATIENTS; BIOLOGICAL-ACTIVITY; BONE METABOLISM; OXIDIZED PTH; KIDNEY; OXIDATION;

D O I：

10.1159/000455289

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

100201 [内科学]; 100221 [泌尿外科学];

摘要：

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. (C) 2017 S. Karger AG, Basel

引用

页码：137 / 142

页数：6

共 62 条

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