Serum intact parathyroid hormone,calcium and phosphorus in accessory diagnosis of kidney disease

Objective To study the serum levels of intact parathyroid hormone(iPTH),calcium(Ca²⁺)and phosphorus(P) in accessory diagnosis of kidney disease. Methods Serum levels of iPTH,Ca²⁺ and P in 231 patients with chronic nephritic syndrome,106 patients with nephritic syndrome,422 patients with chronic renal insufficiency(CRI),and 54 normal subjects who served as controls were measured with Cobas601and Cobas701 automatic analyzers. Results The serum levels of iPTH,Ca²⁺ and P were 37.02(26.61,51.33)pg/ml,(2.16±0.15)mmol/L and(1.25±0.27)mmol/L respectively in patients with chronic nephritic syndrome,29.08(22.65,42.63)pg/ml,(2.00±0.19)mmol/L and(1.27±0.24)mmol/L respectively in those with nephrotic syndrome,38.78(32.39,51.19)pg/ml,(2.32±0.83)mmol/L and(1.16±0.15)mmol/L respectively in controls.The serum Ca²⁺ level was(2.24±0.13)mmol/L,(2.09±0.18)mmol/L,(2.05±0.17)mmol/L and(2.01±0.30)mmol/L respectively in 4 stages of CRI.No significant difference was found in serum levels of iPTH and P between those at de-compensation stage 111.15(75.05,151.50)pg/ml,(1.40±0.31)mmol/L,renal failure stage 187.10(130.20,285.93)pg/ml,(1.64±0.34)mmol/L,uremia stage 269.45(158.70,416.33)pg/ml,(2.09±0.53)mmol/L and controls(P<0.01).However,the serum levels of iPTH and P increased with the severity of renal dysfunction.The serum Ca²⁺ level was significantly higher in patients with kidney disease than in controls(P<0.01).The serum iPTH level was negatively related with the serum Ca²⁺ level in patients at de-compensation stage,renal failure stage and uremia stage,and positively related with the serum levels of iPTH and P in those at renal failure stage and uremia stage. Conclusion Serum levels of iPTH,Ca²⁺ and P can be used as one of the warning factors for renal dysfunction and contribute to the early diagnosis and treatment of different types of renal disease.