Values of Intact Serum Parathyroid Hormone in Different Stages of Renal Insufficiency

Abstract

Intact serum parathyroid hormone (PTH) values were determined in 136 patients consulting the out-patient clinic for renal medicine and in 36 patients on maintenance hemodialysis in order to reveal the extent of parathyroid involvement in different stages of renal insufficiency. Elevated PTH values were found in 53 of the conservatively treated patients and in all but 4 of those on hemodialysis. Serum creatinine values and the duration of uremia correlated significantly to serum PTH, and multivariate analyses revealed that these variables were of dominating importance in determining the extent of PTH elevation. The negative relationship between PTH and plasma ionized calcium indicated maintained calcium regulation of hormone release from the parathyroid, although a relative secretory autonomy seemed to develop in parallel with the functional renal impairment. It is concluded that measurements of intact serum PTH values can demonstrate parathyroid hypersecretion in early renal insufficiency and constitutes a useful tool in the management of patients with renal disease.