Comparison of third and second generation parathyroid hormone assays and their use in chronic hemodialysis patients [Comparación ensayos de parathormona de segunda y tercera generación y su utilidad en hemodializados crónicos]
Muryan A.,Servicio Of Laboratorio Central |
Dicugno M.,Servicio Of Laboratorio Central |
Forrester M.,Hospital Britanico Of Buenos Aires |
de Sampaio E.G.,Servicio Of Laboratorio Central |
And 2 more authors.
Revista de Nefrologia, Dialisis y Trasplante | Year: 2014
Introduction: This work’s objective is to compare third and second generation assays in patients with normal kidney function and in chronic hemodialysis patients, and the implications on the latter. Methods: 60 chronic hemodialysis patients and 40 patients with normal kidney function were studied and their PTH levels were measured for both assays. Results: In patients population with normal kidney function the average on PTH was 51.8 and 45.6 pg/ml with second and third generation assays respectively. In chronic hemodialysis patients the average PTH was 193.9 and 137.1 pg/ml with second and third generation assays respectively. The difference between assays was 11.3% and 29.3% in patients with normal kidney function and in hemodialysis patients respectively. Third generation assay caused a variation in the amount of patients that fall over several PTH ranges according to KDIGO guidelines, for a lesser value of 2 times the reference upper limit: it changes from 20 to 25 patients, between 2 and 9 times: it changes from 31 to 32 patients, and more than 9 times: it changes from 9 to 3 patients. Conclusions: When PTH concentration increases the difference between both assays also increases, for this reason we cannot use them indiscriminately in a chronic hemodialysis patient population. With third generation assays 11 patients (18.3%) changed their classification according to KDIGO guidelines, which will result in a change of treatment. © 2014, Asociacion Regional de Dialisi y Transplantes Renales.