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Ferreira A, Ureǹa P, Ang KS et al: Relationship between serum β2-microglobulin, bone histology and dialysis membranes in uraemic patients. Nephrol Dial Transplant 1995, 10:1701-1707.
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Coen G, Ballantini P, Bonucci E, Sardella D, Taggi F: Bone markers in the diagnosis of low turn-over osteodystrophy in haemodialysis patients [Abstract]. Nephrol Dial Transplant 1996, 11:A41. This study evaluates the predictive value for the diagnosis of ABD and normal bone versus osteitis fibrosa of not only intact PTH but also of TAP and BAP, osteocalcin, deoxypyridinoline, C terminal cross-linked peptide of collagen I and TRAP in a population of 41 Italians slighly exposed to aluminium phosphate binders. It shows that the two best parameters are intact PTH and BAP, their combination predicting low turnover bone disease with a positive predictive value of 73% and high turnover disease with a positive predictive value of 97%.
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Nephrol Dial Transplant
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Ureǹa P, Hruby M, Ferreira A, Ang KS, de Vernejoul MC: Plasma total versus bone alkaline phosphatase as markers of bone turn-over in hemodialysis patients. J Am Soc Nephrol 1996, 7:506-512. This paper shows that BAP measured using the Ostase® kit is higher in patients with high BFR than in those with normal BFR. Unfortunately only one patient out of 17 had low BFR.
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Fournier A, Morinière P, Coevoet B, Makdassi R, Sebert J: Prevention and medical treatment of hyperparathyroidism secondary to renal failure In the adult. In Advance in Nephrology. Edited by Hamburger J. Chicago, USA: Year book Medical Publisher, 1982, 11:241-276.
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Brossard JH, Cloutier M, Roy L, Lepage R, Gascon Barré M, d'Amour P: Accumulation of a non (1-84) molecular form of parthyroid hormone detected by intact PTH assay in renal failure importance in the interpretation of PTH values. J Clin Endocinol Metab 1996, 81:3923-3929. This article shows that the Allegro Kit of the Nichols institute used for the determination of intact PTH measures not only true 1 84 PTH but also another molecular form that, like C terminal fragments, accumulates in uraemia. To have the same concentration of true 1-84 PTH in uraemic patients as in non-uraemic patients, the concentration measured should be 1.57-fold higher. This suggests that dialysis patients with their plasma intact PTH in the optimal range of one- to two-fold the upper limit of normal and normal BFR actually have normal secretion of PTH and therefore no skeletal resistance to the remodelling effect of endogenous PTH.
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J Clin Endocinol Metab
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