Parathyroid hormone measurement in chronic kidney disease – an evolving issue for the nephrologist and the clinical laboratorist: minireview

Abstract

Parathyroid hormone (PTH) is the polypeptide hormone produced by the parathyroid glands, which plays a central role in calcium homeostasis. Circulating PTH must be measured regularly in patients with chronic kidney disease (CKD) – mineral and bone disorders (MBD) to monitor and to adapt treatment with the aim of maintaining PTH levels within a defined narrow range of optimal values for each stage of CKD. Often, for the nephrologists, it is not easy to determine what PTH levels are clinically appropriate. Moreover, the PTH determination also shows many criticisms from the laboratory point of view and there is a clear need to standardize PTH measurements in every phase of the process: pre-analytical, analytical and post-analytical. In this review, all these aspects are summarized with particular reference to the most recent opportunities to improve PTH assays quality on the whole. To this aim, a closer cooperation between nephrologists and clinical laboratories is undoubtedly necessary.

Keywords::

• Parathyroid hormone
• PTH fragments
• immunoassays
• chronic kidney disease
• mineral and bone disorders

Acknowledgments

I thank De Michele GP, Caprio A and Laera G for their professional assistance in the preparation of the paper.

Declaration of interest

The author reports no declaration of interest.