High-Resolution Mass Spectrometry for the Measurement of PTH and PTH Fragments: Insights into PTH Physiology and Bioactivity

Candice Z. Ulmer, Kittrawee Kritmetapak, Ravinder J. Singh, Hubert W. Vesper, Rajiv Kumar

Research output: Contribution to journalReview articlepeer-review

Abstract

Full-length parathyroid hormone (PTH 1-84) is crucial for the regulation of calcium and phosphate homeostasis and bone remodeling. PTH 1-84 is metabolized into various PTH fragments, which are measured with varying levels of efficiency by PTH immunoassays. These PTH fragments, which increase in serum as CKD progresses, could potentially modulate the effects of PTH 1-84 and contribute to CKD-associated bone disorders. To obtain a true biological representation of total PTH bioactivity, it necessary to measure not only PTH 1-84, but also PTH fragments that are present in circulation. Traditional second-generation PTH immunoassays collectively measure PTH 1-84, PTH fragments, and post-translationally modified PTH 1-84, making it difficult to accurately predict the character of underlying renal osteodystrophy. This review highlights current advances in methods available for PTH measurement and the clinical relevance of PTH fragments in CKD. We emphasize the usefulness of mass spectrometry as a potential reference method for PTH measurement.

Original languageEnglish (US)
Pages (from-to)1448-1458
Number of pages11
JournalJournal of the American Society of Nephrology
Volume33
Issue number8
DOIs
StatePublished - Aug 2022

Keywords

  • chronic kidney disease
  • hyperparathyroidism
  • mass spectrometry
  • mineral metabolism
  • parathyroid hormone

ASJC Scopus subject areas

  • Nephrology

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