Non-oxidized parathyroid hormone (PTH) measured by current method is not superior to total PTH in assessing bone turnover in chronic kidney disease

Parathyroid hormone (PTH) is a key regulator of bone turnover but can be oxidized in vivo, which impairs biological activity. Variable PTH oxidation may account for the rather poor correlation with indices chronic kidney disease. Here, we tested whether non-oxidized superior to total as marker 31 patients failure included from an ongoing prospective observational biopsy study and selected cover whole spectrum turnover. Receiver Operating Characteristic (ROC) curves, Spearman regression analysis PTH, markers (bone-specific alkaline phosphatase, procollagen N-terminal pro-peptide tartrate-resistant acid phosphatase 5b) were used assess capability vs. discriminate low non-low high non-high turnover, assessed quantitatively by histomorphometry. Serum levels strongly significantly correlated. Histomorphometric parameters circulating showed similar coefficients PTH. The area under ROC (AUROC) values discriminating between low/non-low significant comparable (0.82 0.79, respectively). For high/non-high AUROCs also same magnitude (0.76 0.80, Thus, measuring using currently available method provides no added value compared indicator failure. disease: clinical relevance?Kidney InternationalVol. 99Issue 5PreviewIn disease, parathyroid (PTH), like all proteins, undergo post-translational modifications, including oxidation. This lead structural functional changes hormone. It has been hypothesized that measurement methods do not adequately reflect PTH-related cardiovascular abnormalities disease owing presence oxidized, biologically inactive circulation. Ursem et al. now report strong serum associations histomorphometric markers, pleading against this hypothesis. Full-Text PDF