The Relationship of Intact Parathyroid Hormone and Ionised Calcium in Secondary Hyperparathyroidism among Hemodialysis Patients

The parathyroid hormone (PTH) is a 115 amino acid precursor molecule; the intact PTH (iPTH) contains only 84 amino acids which is biologically active molecule. The PTH helps in regulation of serum calcium levels, either hyper or hypocalcaemia causes release of PTH. It regulates the serum calcium levels by increasing the flow of calcium from bone to extracellular fluid, by increasing the re-absorption of calcium from renal tubules and it also causes increased intestinal absorption of ionized calcium via Vitamin D. The iPTH is predominantly cleared in liver and kidney, the assay of iPTH is used for differently diagnosis of hypercalcaemia. The iPTH levels will be elevated if hypercalcaemia is due to exaggerated secretion of PTH otherwise it remains normal. Thus total calcium and ionized calcium levels will also be regulated by PTH. Secondary Hyper parathryoidism (SHPT) is a common complication of end stage renal disease (ESRD) in which there is hyperplasia of parathyroid gland. Thus, we conclude that there is an association of iPTH with ionized calcium in patients with SHPT and those undergoing hemodialysis. It is recommended that a by using a universal panel reference range in the assay of iPTH it is possible to minimize the complications in patients with chronic kidney disease.