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Usefulness of whole PTH assay in patients with renal osteodystrophy —Correlation with bone scintigraphy

Abstract

Objective

Intact parathyroid hormone (PTH) assay has recently been reported to be effective in evaluating both 1-84 PTH (whole PTH) and inactive 7-84 PTH. Inactive 7-84 PTH is considered to be increased in hemodialysis patients and to prevent the effects of 1-84 PTH, and intact PTH is considered to overestimate the PTH activity in these patients. As such, a whole PTH assay has recently been developed. The purpose of this study was to examine the usefulness of a whole PTH assay using the bone to soft tissue (B/ST) ratio on bone scintigraphy.

Method

Twenty-five hemodialysis patients were included in our study. In all patients, bone scintigraphy and a blood test [whole PTH, intact PTH, alkaline Phosphatase (ALP), calcium (Ca), and phosphorus (P)] were performed. Regions of interest (ROIs) were drawn around the cranium, lumbar vertebrae, left femoral neck, and soft tissue of the medial left thigh to obtain the B/ST ratio.

Results

The B/ST ratio of the cranium and left femoral neck correlated with whole PTH and intact PTH. In particular, the B/ST ratio of the cranium correlated most significantly with the value of whole PTH. Whole PTH levels correlated with intact PTH levels (r = 0.891, p < 0.0001).

Conclusion

Our data indicate that a whole PTH assay may be useful in evaluating PTH activity using the B/ST ratio. The B/ST ratio of the cranium may reflect the bone metabolism of hemodialysis patients.

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Correspondence to Hayato Kaida or Masatoshi Ishibashi or Hidemi Nishida or Kenkichi Baba or Yuji Hiromatsu or Seiya Okuda or Naofumi Hayabuchi.

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Kaida, H., Ishibashi, M., Nishida, H. et al. Usefulness of whole PTH assay in patients with renal osteodystrophy —Correlation with bone scintigraphy. Ann Nucl Med 19, 179 (2005). https://doi.org/10.1007/BF02984602

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Key words

  • 99mTc-hydroxy-methylene-disphosphonate (99mTc-HMDP)
  • bone scintigraphy
  • whole parathyroid hormone (whole PTH)
  • intact parathyroid hormone (intact PTH)