Positive correlation of serum bio-intact PTH(1-84) but not intact PTH with parathyroid gland size in hemodialysis patients

Background: Little is known about the changes in hemodynamic parameters during arteriovenous (AV) access maturation using duplex ultrasound according to radiocephalic fistula (RCF), brachiocephalic fistula (BCF), and AV graft (AVG) in incident hemodialysis (HD) patient. The objective of this study was to evaluate changes and differences in brachial artery flow rate (BAFR) and related parameters affecting maturation by duplex ultrasound in incident HD patients according to access type. Methods: This study was an observational study conducted from March 2019 to October 2020. During the study period, 109 incident patients underwent new AV access creation, of which 100 were included in the study. The duplex ultrasound was performed on the day prior to access creation, further, day 1, 2 weeks, and 4 weeks later after access creation in incident HD patients. Results: Among all the patients, 38 (38%) received BCF, while 26 (26%) underwent RCF. Of the patients with AVG, 18 (50%) had a forearm loop AVG. The overall mean age was 62.2 ± 13.8 years (range, 32–89). The BAFR increased about 6.9 times in the RCF, 17.4 times in the BCF, and 19.5 times in the AVG at day 1. The median BAFR measured on day 1 was 580.4 mL/min for RC, 1029.0 mL/min for BC, and 1133.0 mL/min for AVG. Relative to the values measured in week 4, the BAFR on day 1 was 69.5% in RCF, 90.6% in BCF, and 93.9% in AVG. The acceleration decreased most significantly on day 1( p < 0.05). The acceleration time increased significantly on day 1 ( p < 0.05) and beyond during maturation in the RCF and BCF. The BAFR of the RCF had a significantly negative correlation with the pulsatility index. The BAFR of the BCF showed a significantly positive correlation with the systolic and diastolic blood pressure but negatively correlated with pulse rate. The BAFR of the AVG showed a significant positive correlation with the diameter of the outflow vein. Conclusions: There were differences in the clinical and duplex parameters during maturation according to access type. The most dramatic changes of duplex parameters were on the day after AV access creation regardless of AV access types. Though RCF had a lower BAFR rate compared to BCF and AVG, it already had a sufficient BAFR required for adequate HD treatment the day after creation. The BAFR of BCF was not different from that of AVG.

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Short- and long-term efficacy of total parathyroidectomy with immediate autografting compared with subtotal parathyroidectomy in hemodialysis patients.

Journal of the American Society of Nephrology ◽

10.1681/asn.v341008 ◽

1992 ◽

Vol 3 (4) ◽

pp. 1008-1017 ◽

Cited By ~ 2

Author(s):

E R Gagné ◽

P Ureña ◽

S Leite-Silva ◽

J Zingraff ◽

A Chevalier ◽

...

Keyword(s):

Parathyroid Gland ◽

Great Majority ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Total Parathyroidectomy ◽

Short Term ◽

Subtotal Parathyroidectomy ◽

Surgical Methods ◽

Long Term Follow Up

A retrospective study was performed in chronic hemodialysis patients comparing total parathyroidectomy (PTX) followed by immediate autografting (IA) (total PTX+IA) with subtotal parathyroidectomy (subtotal PTX). One hundred six patients with severe, uncontrolled hyperparathyroidism were referred to this center and underwent surgery during the period from 1980 to 1990. Long-term follow-up after PTX was available in 49 of them: 28 patients had total PTX+IA and 21 had subtotal PTX. The two surgical methods were evaluated with respect to preoperative severity of hyperparathyroidism, immediate postoperative results, and long-term parathyroid status, as evaluated by an RIA measuring intact immunoreactive parathyroid hormone (intact iPTH; normal values, 15 to 65 pg/mL). The initial degree of hyperparathyroidism was comparable in the two groups. An excellent short-term control of hyperparathyroidism was achieved in the great majority (95%) of patients with either surgical procedure. However, long-term normalization of parathyroid gland activity was achieved in only one third of patients whereas 33% had elevated intact iPTH levels (> 130 pg/mL; i.e., higher than twice the upper range of normal) and 32% had low intact iPTH levels (< 15 pg/mL), consistent with permanent hypoparathyroidism. No difference was found in the immediate failure rates: 0 of 28 cases after total PTX+IA compared with 2 of 21 cases after subtotal PTX. Similarly, long-term intact iPTH levels were comparable: 400 +/- 105 versus 212 +/- 82 pg/mL (mean +/- SE; P = not significant). Interestingly, long-term serum intact iPTH levels were higher in patients with nodular (N = 18) than with diffusely (N = 26) hyperplastic glands: 556 +/- 146 versus 126 +/- 52 pg/mL (P < 0.001) and recurrence of hyperparathyroidism was more frequent with nodular hyperplasia (11 of 18) than with diffuse hyperplasia (4 of 26) (P < 0.02). In conclusion, although excellent short-term results were obtained with both procedures, satisfactory long-term control of parathyroid gland function was achieved in only one third of the patients, the other two third remaining either hypoparathyroid or developing recurrent hyperparathyroidism. Last, the histological subtype of parathyroid glands was partially predictive of the recurrence of hyperparathyroidism.

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Reduction of whole PTH/intact PTH ratio as a predictor of bone metabolism in cinacalcet treatment of hemodialysis patients with secondary hyperparathyroidism

Osteoporosis International ◽

10.1007/s00198-010-1262-x ◽

2010 ◽

Vol 22 (3) ◽

pp. 923-930 ◽

Cited By ~ 11

Author(s):

M. Kurajoh ◽

M. Inaba ◽

S. Okuno ◽

H. Nagayama ◽

S. Yamada ◽

...

Keyword(s):

Secondary Hyperparathyroidism ◽

Bone Metabolism ◽

Hemodialysis Patients ◽

Intact Pth ◽

Whole Pth

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Restoration of reversed whole PTH/intact PTH ratio and reduction in parathyroid gland vascularity during cinacalcet therapy for severe hyperparathyroidism in a uraemic patient

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfp578 ◽

2009 ◽

Vol 25 (2) ◽

pp. 638-641 ◽

Cited By ~ 8

Author(s):

H. Komaba ◽

J. Shin ◽

M. Fukagawa

Keyword(s):

Parathyroid Gland ◽

Uraemic Patient ◽

Intact Pth ◽

Whole Pth

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Diagnostic accuracy of internal jugular vein ultrasound in quantification of the central venous pressure for hemodialysis patients

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00661-4 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Ahmed Abd Alrahman Baz ◽

Amro Abdulrahim Ibrahim ◽

Hussein Saeed El-Fishawy ◽

Abo El-Magd Mohamed Al-Bohy

Keyword(s):

Central Venous Pressure ◽

Internal Jugular Vein ◽

Significant Positive Correlation ◽

Jugular Vein ◽

Venous Pressure ◽

Hemodialysis Patients ◽

Central Venous ◽

Positive Correlation ◽

Non Invasive ◽

Accuracy Measures

Abstract Background Assessment of the central venous pressure (CVP) is an essential hemodynamic parameter for monitoring the dialyzing patients. Our objective of the present study is to investigate the accuracy of CVP measurement by internal jugular vein US in comparison to the direct measurement by the central venous catheters for hemodialysis patients. We included 106 patients; where their CVP was assessed in two different non invasive US methods (CVPni) separately and in combination and the obtained measurements were correlated to the invasive measurements (CVPi) by catheters. Results By method 1, there is a highly significant positive correlation between CVPni and CVPi (ρ < 0.001) and a Pearson correlation coefficient (r = 0.913 n = 93), and by method 2, there is also a highly significant positive correlation between the CVPni and CVPi in both groups (r = 0.832, 95%, n = 106, p < 0.001), 1.935 was the cut-off point for prediction of CVP ≥ 10cmH20. For differentiation between patients with CVP < 10cmH20 and ≥ 10cmH20, the accuracy measures (sensitivity, specificity, PPV, NPV, and overall accuracy) were 100%, 79.31%, 74.47%, 100%, and 87.10% by method 1, and were 91.11%, 85.48%, 82.00%, 92.98%, and 87.85% by method 2, while the combination of both methods had gained 88.57%, 89.66%, 83.78%, 92.86%, and 89.25%, respectively. Conclusion The US offered a reliable and non-invasive tool for monitoring CVP. The present study has a novelty of combining more than one US method and this had reported higher accuracy measures and outperformed the use of a single method.

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Four chronic hemodialysis patients whose intact-PTH level markedly decreased after administration of saccharated iron.

Nihon Toseki Igakkai Zasshi ◽

10.4009/jsdt.28.261 ◽

1995 ◽

Vol 28 (3) ◽

pp. 261-265

Author(s):

Masanori Shibata ◽

Hideo Uchiyama ◽

Mitsuo Fukushima ◽

Shinkichi Taniguchi ◽

Kazumasa Usami

Keyword(s):

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Intact Pth ◽

Pth Level

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Quality of life, depression and self-perceived burden among geriatric and non-geriatric hemodialysis patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213064 ◽

2021 ◽

Vol 9 (8) ◽

pp. 2225

Author(s):

Kenan Evren Oztop ◽

Ferhat Cetin ◽

Ahmed Bilal Genc ◽

Ceyhun Varim ◽

Savas Sipahi

Keyword(s):

Quality Of Life ◽

Significant Positive Correlation ◽

Depression Scale ◽

Hemodialysis Patients ◽

Life Questionnaire ◽

Care Burden ◽

Positive Correlation ◽

Perceived Burden ◽

Quality Of Life Scale

Background: Many hemodialysis patients need support at various levels from their relatives while performing their daily activities. The ‘burden’ of these needs of patients on their relatives and their negative effects on their lives have been shown in the literature. The aim of the study was to evaluate the ‘care burden’ in terms of the patient.Methods: The patient who had received hemodialysis for at least 3 months was included in the study. A patient identification form including demographic data and medical history data was prepared. The Perceived care burden scale, Beck depression scale and WHO Quality of life questionnaire were applied to the patients.Results: A statistically significant positive correlation was found between SPBS and BDI (p<0.001, r=0.820). A statistically significant negative correlation was observed between the perceived care burden and all sub-dimensions of the quality of life scale (p<0.001). The frequency of comorbidity in the geriatric group was higher than non-geriatric group. A statistically significant positive correlation was found between comorbidity and QOL (p<0.001). The median scores of all sub-dimensions of the QOL scale were lower in geriatric group and there were significance differences except environment dimension.Conclusions: The self-perceived burden on caregivers of hemodialysis patients was positively associated with depression and negatively associated with QOL. Decrease in QOL was more pronounced in geriatric patients.

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Decreases in Parathyroid Gland Volume after Cinacalcet Treatment in Hemodialysis Patients with Secondary Hyperparathyroidism

Nephron Clinical Practice ◽

10.1159/000313035 ◽

2010 ◽

Vol 115 (3) ◽

pp. c195-c202 ◽

Cited By ~ 16

Author(s):

Mitsuru Ichii ◽

Eiji Ishimura ◽

Senji Okuno ◽

Hidenori Chou ◽

Yoko Kato ◽

...

Keyword(s):

Secondary Hyperparathyroidism ◽

Parathyroid Gland ◽

Hemodialysis Patients ◽

Gland Volume

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Technical and Clinical Characterization of the Bio-PTH (1–84) Immunochemiluminometric Assay and Comparison with a Second-Generation Assay for Parathyroid Hormone

Clinical Chemistry ◽

10.1373/clinchem.2003.026831 ◽

2004 ◽

Vol 50 (2) ◽

pp. 385-390 ◽

Cited By ~ 54

Author(s):

Masaaki Inaba ◽

Kiyoshi Nakatsuka ◽

Yasuo Imanishi ◽

Masakazu Watanabe ◽

Yuji Mamiya ◽

...

Keyword(s):

Parathyroid Hormone ◽

Calibration Curve ◽

Second Generation ◽

Japanese Patients ◽

Hemodialysis Patients ◽

Intact Pth ◽

Technical Performance ◽

The Mean ◽

Fold Excess

Abstract Background: The Bio-Intact parathyroid hormone (1–84) assay (Bio-PTH), a newly developed two-site immunochemiluminometric assay, measures exclusively PTH (1–84) in contrast to second-generation “intact PTH” (I-PTH) assays. We investigated the technical performance and clinical significance of this new assay. Methods: PTH was measured simultaneously by the Bio-PTH assay and Allegro intact PTH IRMA in sera from Japanese patients with calcium disorders. Results: Measured Bio-PTH in serum was unaffected by six freeze-thaw cycles and was stable at 4 °C for 7 days and during storage at −20 or −80 °C over 28 days. The calibration curve was linear to 1800 ng/L. The detection limit was 3.9 ng/L. The intra- and interassay imprecision was <2.8% and 3.5%, respectively, for analyte concentrations spanning the range of the calibration curve. Bio-PTH was unaffected by a 1000-fold excess of PTH (7–84), although I-PTH reacted equally with PTH (7–84) and PTH (1–84). Bio-PTH was correlated with I-PTH in healthy individuals (r = 0.953; P <0.0001; n = 26) and in the full population without renal dysfunction (r = 0.994; P <0.0001; n = 62). In 72 volunteers, mean (SD) Bio-PTH was 22.2 (7.1) ng/L, or 62% of the mean I-PTH [36.1 (22.3) ng/L]. This ratio was 51% in hemodialysis patients (n = 177). Mean Bio-PTH was high in patients with primary hyperparathyroidism [121 (85) ng/L; n = 18] and hemodialysis patients [102 (104) ng/L; n = 177], low in idiopathic hypoparathyroidism [5.5 (2.8) ng/L; n = 4], and within 2 SD of the mean for healthy controls in Paget disease of the bone [34 (15) ng/L; n = 9] and bone metastasis [24 (12) ng/L; n = 8]. Conclusion: The Bio-PTH assay is sensitive and precise and produces expected results for patients with the studied disorders of calcium metabolism.

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