Abstract: FR-PO297

Effects of Parathyroidectomy on Plasma Different Parathyroid Hormone Fragments Levels in CKD Patients

Session Information

Category: Mineral Disease

  • 1202 Mineral Disease: Vitamin D, PTH, FGF-23

Authors

  • Wang, Ningning, Department of Nephrology,The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
  • Chen, Huimin, Department of Nephrology,The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
  • Zha, Xiaoming, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIangSu, China
  • Xing, Chang Ying, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIangSu, China
Background


Intact parathyroid hormone (iPTH) measured by the second generation assays include not only (1-84)PTH, but also (7-84)PTH. Now the third generation PTH assays have been shown specific test for (1-84)PTH . Here we investigated the levels of plasma iPTH, (1-84)PTH, (7-84)PTH in stage 5 chronic kidney disease (CKD) patients, and evaluate the effects of parathyroidectomy(PTX) on above parameters in severe secondary hyperparathyroidism(SHPT) subgroups.

Methods

We included 252 CKD patients divided by baseline plasma iPTH levels. Thirty-one PTX patients were followed up with median time of 7.1 months. Serum iPTH and (1-84)PTH were measured by electrochemiluminescence immunoassay. (7-84)PTH levels were calculated by subtracting the (1-84)PTH values from the iPTH values.

Results


Plasma iPTH, (1-84)PTH, (7-84)PTH levels were closely related with each other, while (1-84)PTH/iPTH gradually reduced with upregulated iPTH levels. For CKD subgroups with plasma iPTH level>800 pg/ml, (1-84)PTH/iPTH furtherly decreased to 0.5(Fig1). After PTX, plasma different PTH fragments levels were decreased obviously and (1-84)PTH/iPTH were increased in severe SHPT patients(Table 1).

Conclusion

PTX can diminish abnormal increased iPTH, (1-84)PTH,(7-84)PTH levels and upregulate (1-84)PTH/iPTH for severe SHPT patients. Blood iPTH value may overestimate the severity of SHPT. Measurement of (1-84)PTH is suggested for accurate diagnosis and treatment in chronic kidney disease-mineral and bone disorder(CKD-MBD) patients.

PTX can diminish blood PTH fragments levels and upregulate (1-84)PTH/iPTH in severe SHPT patients
VariablePre-PTXPost-PTX
iPTH (pg/mL)1662.0(965.7-2344.0)67.9(44.0-125.9)*
(1-84)PTH (pg/mL)773.0(495.4-1030.0)53.6(35.9-90.5)*
(7-84)PTH (pg/mL)749.0(591.8-1261.0)12.9(5.1-41.5)*
(1-84)PTH/iPTH0.5±0.10.8±0.2*

*,compared with Pre-PTX group, P<0.001

Characteristics of blood bone markers and different PTH fragments grouped by baseline plasma iPTH values

Funding

  • Government Support - Non-U.S.