Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2009 Jul;24(7):1355-61.
doi: 10.1007/s00467-009-1143-8. Epub 2009 Mar 20.

Response of different PTH assays to therapy with sevelamer or CaCO3 and active vitamin D sterols

Katherine Wesseling-Perry  1 , G Chris Harkins, He-Jing Wang, Shobha Sahney, Barbara Gales, Robert M Elashoff, Harald Jüppner, Isidro B Salusky
Affiliations
Randomized Controlled Trial

Response of different PTH assays to therapy with sevelamer or CaCO3 and active vitamin D sterols

Katherine Wesseling-Perry et al. Pediatr Nephrol. 2009 Jul.

Abstract

Amino-terminally truncated parathyroid hormone (PTH) fragments are detected to differing degrees by first- and second-generation immunometric PTH assays (PTH-IMAs), and acute changes in serum calcium affect the proportion of these fragments in circulation. However, the effect of chronic calcium changes and different vitamin D doses on these PTH measurements remains to be defined. In this study, 60 pediatric dialysis patients, aged 13.9 +/- 0.7 years, with secondary hyperparathyroidism were randomized to 8 months of therapy with oral vitamin D combined with either calcium carbonate (CaCO(3)) or sevelamer. Serum phosphorus levels did not differ between groups. Serum calcium levels rose from 9.3 +/- 0.1 to 9.7 +/- 0.1 mg/dl during CaCO(3) therapy (p < 0.01 from baseline) but remained unchanged during sevelamer therapy. In the CaCO(3) and sevelamer groups, baseline serum PTH levels (1st PTH-IMA; Nichols Institute Diagnostics, San Clemente, CA) were 964 +/- 75 and 932 +/- 89 pg/ml, and levels declined to 491 +/- 55 and 543 +/- 59 pg/ml, respectively (nonsignificant between groups). Patients treated with sevelamer received higher doses of vitamin D than those treated with CaCO(3). The PTH values obtained by first- and second-generation PTH-IMAs correlated closely throughout therapy and the response of PTH was similar to both PTH-IMAs, despite differences in serum calcium levels.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Serum phosphorus (squares) and calcium (circles) levels throughout the study in patients treated with CaCO3 (closed symbols) versus sevelamer (open symbols). The asterisk indicates a significant change from baseline (p < 0.01), while the double dagger indicates a difference between the sevelamer and CaCO3 treatment groups (p < 0.01)
Fig. 2
Fig. 2
Serum parathyroid hormone (PTH) values throughout the course of the study in patients treated with CaCO3 (a) and those treated with sevelamer (b). PTH levels were determined by the first-generation immunometric assay by Nichols (1st PTH-IMA; closed diamonds) and by the 1st PTH-IMA (open diamonds) and second-generation (2nd) PTH-IMA (closed triangles) by Immutopics. The asterisk indicates a significant (p < 0.01) decrease from baseline
See this image and copyright information in PMC

References

    1. Quarles LD, Lobaugh B, Murphy G. Intact parathyroid hormone overestimates the presence and severity of parathyroid-mediated osseous abnormalities in uremia. J Clin Endocrinol Metab. 1992;75(1):145–150. - PubMed
    1. Jüppner H, Potts JT., Jr Immunoassays for the detection of parathyroid hormone. J Bone Miner Res 17 Suppl. 2002;2:N81–N86. - PubMed
    1. Brossard JH, Cloutier M, Roy L, Lepage R, Gascon-Barre M, D’Amour P. Accumulation of a non-(1–84) molecular form of parathyroid hormone (PTH) detected by intact PTH assay in renal failure: importance in the interpretation of PTH values. J Clin Endocrinol Metab. 1996;81(11):3923–3929. - PubMed
    1. Lepage R, Roy L, Brossard JH, Rousseau L, Dorais C, Lazure C, D’Amour P. A non-(1–84) circulating parathyroid hormone (PTH) fragment interferes significantly with intact PTH commercial assay measurements in uremic samples. Clin Chem. 1998;44(4):805–809. doi: 10.1093/clinchem/44.4.805. - DOI - PubMed
    1. Boudou P, Ibrahim F, Cormier C, Sarfati E, Souberbielle JC. Unexpected serum parathyroid hormone profiles in some patients with primary hyperparathyroidism. Clin Chem. 2006;52(4):757–760. doi: 10.1373/clinchem.2005.060962. - DOI - PubMed

Publication types

MeSH terms