The PTH (1-84)/non-PTH (1-84) ratio is a risk factor for cardiovascular events in hemodialysis patients

Clinical Nephrology

Volumn 75, Issue 4, 2011, Pages 309-318

  Zitt, E ^a,b,c   Kirsch, A H ^a   Haueis, M ^a   Strasak, A ^a   Neyer, U ^b,c   Mayer, G ^a   Rosenkranz, A R ^a  

^a INNSBRUCK MEDICAL UNIVERSITY   (Austria)

^b ACADEMIC TEACHING HOSPITAL FELDKIRCH   (Austria)

^c Vorarlberg Institute for Vascular Investigation and Treatment VIVIT   (Austria)

Author keywords

Cardiovascular morbidity; Cardiovascular mortality; Hemodialysis; PTH; PTH (1 84) non PTH (1 84) ratio; Secondary hyperparathyroidism

Indexed keywords

ALUMINUM HYDROXIDE; PARATHYROID HORMONE; SEVELAMER; VITAMIN D; BIOLOGICAL MARKER;

ACUTE CORONARY SYNDROME; ADULT; AGED; ARTICLE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; COHORT ANALYSIS; DISEASE ASSOCIATION; EVENT FREE SURVIVAL; FEMALE; FOLLOW UP; HEMODIALYSIS PATIENT; HUMAN; KIDNEY FAILURE; MAJOR CLINICAL STUDY; MALE; MORTALITY; PARATHYROID HORMONE BLOOD LEVEL; PROSPECTIVE STUDY; RISK ASSESSMENT; SECONDARY HYPERPARATHYROIDISM; SUDDEN DEATH; ANALYSIS OF VARIANCE; BLOOD; CHRONIC KIDNEY FAILURE; DISEASE FREE SURVIVAL; MIDDLE AGED; PROPORTIONAL HAZARDS MODEL; RENAL REPLACEMENT THERAPY; RISK FACTOR;

AGED; ANALYSIS OF VARIANCE; BIOLOGICAL MARKERS; CARDIOVASCULAR DISEASES; DISEASE-FREE SURVIVAL; FEMALE; HUMANS; KIDNEY FAILURE, CHRONIC; MALE; MIDDLE AGED; PARATHYROID HORMONE; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; RENAL DIALYSIS; RISK FACTORS;

EID: 79960969184     PISSN: 03010430     EISSN: None     Source Type: Journal    
DOI: 10.5414/CNP75309     Document Type: Article

References (40)

1. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998; 32: 112-119.
2. Stenvinkel P, Carrero JJ, Axelsson J, Lindholm B, Heimburger O, Massy Z. Emerging biomarkers for evaluating cardiovascular risk in the chronic kidney disease patient: How do new pieces fit into the uremic puzzle? Clin J Am Soc Nephrol. 2008; 3: 505-521.
3. Covic A, Kothawala P, Bernal M, Robbins S, Chalian A, Goldsmith D. Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease. Nephrol Dial Transplant. 2009; 24: 1506-1523.
4. Hagstrom E, Hellman P, Larsson TE, Ingelsson E, Berglund L, Sundstrom J, Melhus H, Held C, Lind L, Michaelsson K, Arnlov J. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community. Circulation. 2009; 119: 2765-2771.
5. Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004; 15: 2208-2218.
6. Melamed ML, Eustace JA, Plantinga L, Jaar BG, Fink NE, Coresh J, Klag MJ, Powe NR. Changes in serum calcium, phosphate, and PTH and the risk of death in incident dialysis patients: A longitudinal study. Kidney Int. 2006; 70: 351-357.
7. Kovesdy CP, Ahmadzadeh S, Anderson JE, Kalantar-Zadeh K. Secondary hyperparathyroidism is associated with higher mortality in men with moderate to severe chronic kidney disease. Kidney Int. 2008; 73: 1296-1302.
8. Tentori F, Blayney MJ, Albert JM, Gillespie BW, Kerr PG, Bommer J, Young EW, Akizawa T, Akiba T, Pisoni RL, Robinson BM, Port FK. Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: The dialysis outcomes and practice patterns study (dopps). Am J Kidney Dis. 2008; 52: 519-530.
9. Avram MM, Sreedhara R, Avram DK, Muchnick RA, Fein P. Enrollment parathyroid hormone level is a new marker of survival in hemodialysis and peritoneal dialysis therapy for uremia. Am J Kidney Dis. 1996; 28: 924-930.
10. Foley RN, Parfrey PS, Harnett JD, Kent GM, Hu L, O'Dea R, Murray DC, Barre PE. Hypocalcemia, morbidity, and mortality in end-stage renal disease. Am J Nephrol. 1996; 16: 386-393.
11. Stenvinkel P, Pecoits-Filho R, Lindholm B. Coronary artery disease in end-stage renal disease: No longer a simple plumbing problem. J Am Soc Nephrol. 2003; 14: 1927-1939.
12. D'Amour P, Rakel A, Brossard JH, Rousseau L, Albert C, Cantor T. Acute regulation of circulating parathyroid hormone (PTH) molecular forms by calcium: Utility of PTH fragments/PTH(1-84) ratios derived from three generations of PTH assays. J Clin Endocrinol Metab. 2006; 91: 283-289.
13. Friedman PA, Goodman WG. PTH(1-84)/PTH(7-84): A balance of power. Am J Physiol Renal Physiol. 2006; 290: 975-984.
14. Divieti P, John MR, Juppner H, Bringhurst FR. Human PTH-(7-84) inhibits bone resorption in vitro via actions independent of the type 1 PTH/ PTHrP receptor. Endocrinology. 2002; 143: 171-176.
15. Nguyen-Yamamoto L, Rousseau L, Brossard JH, Lepage R, D'Amour P. Synthetic carboxyl-terminal fragments of parathyroid hormone (PTH) decrease ionized calcium concentration in rats by acting on a receptor different from the PTH/PTH-related peptide receptor. Endocrinology. 2001; 142: 1386-1392.
16. Brossard JH, Cloutier M, Roy L, Lepage R, Gascon-Barre M, D'Amour P. Accumulation of a non-(1-84) molecular form of parathyroid hormone (pth) detected by intact pth assay in renal failure: Importance in the interpretation of pth values. J Clin Endocrinol Metab. 1996; 81: 3923-3929.
17. Koller H, Zitt E, Staudacher G, Neyer U, Mayer G, Rosenkranz AR. Variable parathyroid hormone (1-84)/carboxylterminal pth ratios detected by 4 novel parathyroid hormone assays. Clin Nephrol. 2004; 61: 337-343.
18. Melamed ML, Eustace JA, Plantinga LC, Jaar BG, Fink NE, Parekh RS, Coresh J, Yang Z, Cantor T, Powe NR. Third-generation parathyroid hormone assays and all-cause mortality in incident dialysis patients: The choice study. Nephrol Dial Transplant. 2008; 23: 1650-1658.
19. Monier-Faugere MC, Mawad H, Malluche HH. Opposite effects of calcitriol and paricalcitol on the parathyroid hormone-(1-84)/large carboxyterminal-parathyroid hormone fragments ratio in patients with stage 5 chronic kidney disease. Clin J Am Soc Nephrol. 2007; 2: 1255-1260.
20. Cantor TL. The opposing actions of the two parathyroid hormones, 1-84 pth and 7-84 pth: Improvement in renal bone and calcium metabolism management. Hemodial Int. 2004; 8: 372-385.
21. Monier-Faugere MC, Geng Z, Mawad H, Friedler RM, Gao P, Cantor TL, Malluche HH. Improved assessment of bone turnover by the PTH (1-84)/ large c-PTH fragments ratio in esrd patients. Kidney Int. 2001; 60: 1460-1468.
22. Coen G, Manni M, Mantella D, Pierantozzi A, Balducci A, Condo S, DiGiulio S, Yancovic L, Lippi B, Manca S, Morosetti M, Pellegrino L, Simonetti G, Gallucci MT, Splendiani G. Are PTH serum levels predictive of coronary calcifications in haemodialysis patients? Nephrol Dial Transplant. 2007; 22: 3262-3267.
23. Kimata N, Albert JM, Akiba T, Yamazaki S, Kawaguchi T, Fukuhara S, Akizawa T, Saito A, Asano Y, Kurokawa K, Pisoni RL, Port FK. Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: The Japan dialysis outcomes and practice patterns study. Hemodial Int. 2007; 11: 340-348.
24. London GM, Marty C, Marchais SJ, Guerin AP, Metivier F, de Vernejoul MC. Arterial calcifications and bone histomorphometry in end-stage renal disease. J Am Soc Nephrol. 2004; 15: 1943-1951.
25. Braun J. Extraosseous calcification in patients with chronic renal failure - no escape? Nephrol Dial Transplant. 2005; 20: 2054-2059.
26. Moe SM. Vascular calcification and renal osteodystrophy relationship in chronic kidney disease. Eur J Clin Invest. 2006; 36 (Suppl): 51-62.
27. Noordzij M, Korevaar JC, Boeschoten EW, Dekker FW, Bos WJ, Krediet RT. The kidney disease outcomes quality initiative (K/DOQI) guideline for bone metabolism and disease in CKD: Association with mortality in dialysis patients. Am J Kidney Dis. 2005; 46: 925-932.
28. Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: A national study.AmJ Kidney Dis. 1998; 31: 607-617.
29. Slatopolsky E, Finch J, Clay P, Martin D, Sicard G, Singer G, Gao P, Cantor T, Dusso A.Anovel mechanism for skeletal resistance in uremia. Kidney Int. 2000; 58: 753-761.
30. Bogin E, Massry SG, Harary I. Effect of parathyroid hormone on rat heart cells. J Clin Invest. 1981; 67: 1215-1227.
31. Amann K, Ritz E, Wiest G, Klaus G, Mall G. Arole of parathyroid hormone for the activation of cardiac fibroblasts in uremia. J Am Soc Nephrol. 1994; 4: 1814-1819.
32. Amann K, Tornig J, Flechtenmacher C, Nabokov A, Mall G, Ritz E. Blood-pressure-independent wall thickening of intramyocardial arterioles in experimental uraemia: Evidence for a permissive action of PTH. Nephrol Dial Transplant. 1995; 10: 2043-2048.
33. Rashid G, Bernheim J, Green J, Benchetrit S. Parathyroid hormone stimulates endothelial expression of atherosclerotic parameters through protein kinase pathways. Am J Physiol Renal Physiol. 2007; 292: 1215-1218.
34. Neves KR, Graciolli FG, dos Reis LM, Graciolli RG, Neves CL, Magalhaes AO, Custodio MR, Batista DG, Jorgetti V, Moyses RM. Vascular calcification: Contribution of parathyroid hormone in renal failure. Kidney Int. 2007; 71: 1262-1270.
35. Lehmann G, Stein G, Huller M, Schemer R, Ramakrishnan K, Goodman WG. Specific measurement of PTH (1-84) in various forms of renal osteodystrophy (rod) as assessed by one histomorphometry. Kidney Int. 2005; 68: 1206-1214.
36. Coen G, Bonucci E, Ballanti P, Balducci A, Calabria S, Nicolai GA, Fischer MS, Lifrieri F, Manni M, Morosetti M, Moscaritolo E, Sardella D. PTH 1-84 and PTH "7-84" In the noninvasive diagnosis of renal bone disease. Am J Kidney Dis. 2002; 40: 348-354.
37. Herberth J, Branscum AJ, Mawad H, Cantor T, Monier-Faugere MC, Malluche HH. Intact PTH combined with the PTH ratio for diagnosis of bone turnover in dialysis patients: diagnostic test study. Am J Kidney Dis. 2010; 55: 897-906.
38. Drechsler C, Krane V, Grootendorst DC, Ritz E, Winkler K, Marz W, Dekker F, Wanner C. The association between parathyroid hormone and mortality in dialysis patients is modified by wasting. Nephrol Dial Transplant. 2009; 24: 3151-3157.
39. Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, Franch H, Guarnieri G, Ikizler TA, Kaysen G, Lindholm B, Massy Z, Mitch W, Pineda E, Stenvinkel P, Trevino-Becerra A, Wanner C. Aproposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008; 73: 391-398.
40. Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, Held PJ, Port FK. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999; 341: 1725-1730.