TY - JOUR
T1 - Intravenous vitamin D therapy reduces PTH-(1-84)/large C fragments ratio in chronic hemodialysis patients
AU - Kihara, Takashi
AU - Ichikawa, Haruo
AU - Morimoto, Hisanori
AU - Yano, Ai
AU - Akagi, Shigeru
AU - Nakao, Kazushi
AU - Kohmoto, Hiroko
AU - Wada, Jun
AU - Kumagai, Isao
AU - Makino, Hirofumi
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2004
Y1 - 2004
N2 - Background: Renal osteodystrophy is one of the major complications in patients with chronic renal failure. Large C-PTH fragments are secreted from the parathyroid glands and exert antagonistic actions against PTH-(1-84). The PTH-(1-84)/large C-PTH fragments ratio reflects both biosynthesis and processing of PTH; however the alteration of the ratio under vitamin D therapy has not been investigated. Methods: Seventeen hemodialysis patients with intact PTH levels of >300 pg/ml were enrolled. Calcitriol or maxacalcitol were administered intravenously for 78 weeks. Intact PTH, PTH-(1-84), and the PTH-(1-84)/large C-PTH fragments ratio were measured at 0, 13, 26, 52 and 78 weeks. Results: Intact PTH and PTH-(1-84) levels, which were 492.0 ± 115.7 and 303.4 ± 105.4 pg/ml, respectively, at baseline, significantly decreased at the end of the study to 268.9 ± 121.9 (p < 0.0001) and 190.7 ± 106.9 pg/ml (p = 0.0008), respectively. In contrast, large C-PTH fragments, which were 152.7 ± 53.5 pg/ml at baseline, did not significantly change at 78 weeks (144.5 ± 72.2 pg/ml, p = 0.7612). Consequently, the PTH-(1-84)/large C-PTH fragments ratio was significantly reduced from 2.25 ± 1.31 to 1.47 ± 0.89 (p = 0.0004). Conclusion: The PTH-(1-84)/large C-PTH fragments ratio refl ects the change of PTH biosynthesis, processing and secretion from the parathyroid glands, and it may be a beneficial marker to evaluate the overall biological PTH action and predict bone turnover status in hemodialysis patients under intravenous vitamin D therapy.
AB - Background: Renal osteodystrophy is one of the major complications in patients with chronic renal failure. Large C-PTH fragments are secreted from the parathyroid glands and exert antagonistic actions against PTH-(1-84). The PTH-(1-84)/large C-PTH fragments ratio reflects both biosynthesis and processing of PTH; however the alteration of the ratio under vitamin D therapy has not been investigated. Methods: Seventeen hemodialysis patients with intact PTH levels of >300 pg/ml were enrolled. Calcitriol or maxacalcitol were administered intravenously for 78 weeks. Intact PTH, PTH-(1-84), and the PTH-(1-84)/large C-PTH fragments ratio were measured at 0, 13, 26, 52 and 78 weeks. Results: Intact PTH and PTH-(1-84) levels, which were 492.0 ± 115.7 and 303.4 ± 105.4 pg/ml, respectively, at baseline, significantly decreased at the end of the study to 268.9 ± 121.9 (p < 0.0001) and 190.7 ± 106.9 pg/ml (p = 0.0008), respectively. In contrast, large C-PTH fragments, which were 152.7 ± 53.5 pg/ml at baseline, did not significantly change at 78 weeks (144.5 ± 72.2 pg/ml, p = 0.7612). Consequently, the PTH-(1-84)/large C-PTH fragments ratio was significantly reduced from 2.25 ± 1.31 to 1.47 ± 0.89 (p = 0.0004). Conclusion: The PTH-(1-84)/large C-PTH fragments ratio refl ects the change of PTH biosynthesis, processing and secretion from the parathyroid glands, and it may be a beneficial marker to evaluate the overall biological PTH action and predict bone turnover status in hemodialysis patients under intravenous vitamin D therapy.
KW - PTH-(1-84)/large C-PTH fragments ratio
KW - Parathyroid hormone
KW - Vitamin D i.v. therapy
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U2 - 10.1159/000080680
DO - 10.1159/000080680
M3 - Article
C2 - 15528944
AN - SCOPUS:8344228415
VL - 98
SP - c93-c100
JO - Nephron - Clinical Practice
JF - Nephron - Clinical Practice
SN - 1660-2110
IS - 3
ER -