PEDIATRIC INFORMATION
Presentations
Abstracts
Article Abstracts
PTH Glossary
7-84 PTH Science
Articles
References

Scantibodies Clinical Lab cares about you and your patients. We want to show this caring our commitment by sharing some vital information and discoveries that have been made relative to the parathyroid hormone and PTH testing within the last few months years. To that end, here are some key points of information:

  • 7-84 PTH is now recognized as the 2nd PTH hormone. It is produced by the parathyroid gland, like 1-84 PTH, but is hypocalcemic and has an inverse action to 1-84 PTH in the body.
    1. 1-84 PTH raises bone turnover necessary for bone growth
    2. 7-84 PTH lowers bone turnover
  • Using this 7-84 PTH hormone in a ratio of 1-84 PTH/7-84 PTH accurately predicts adynamic bone disease, which afflicts 50% of ESRD patients, and can be used to explain growth retardation in ESRD pediatric patients.
    1. Three groups of 54 children on dialysis were divided according to their growth velocity.
      1. Group 1 grew below the median growth velocity rate for ESRD children.
      2. Group 2 grew at the median growth velocity rate.
      3. Group 3 exceeded the median growth velocity rate.
  • Surprisingly, it was found that the groups were divided according to this 1-84 PTH/7-84 PTH ratio.
    1. The first group had ratios of < 1.85
    2. The second group had ratios of 1-85 – 2.75
    3. The third group had ratios of > 2.85 which corresponds to the ratios for non-uremic children.
  • The following charts summarize that research. Dr. Simon Waller’s presentation of his research is available in book form from Scantibodies Clinical Laboratory. (see # 9).

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    Bone biopsy procedures have also demonstrated that a measure of intact PTH or a single 1-84 PTH alone CANNOT identify the majority of adynamic bone disease patients compared to the 1-84 PTH/7-84 PTH ratio, because they do not measure the hypocalcemic 7-84 hormone separately.

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    A ratio of 1-84 PTH/7-84 PTH has been shown (through bone biopsies) to be 94% accurate in identifying patients with adynamic bone disease.

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    For African-American ESRD patients, this is particularly problematic. Dr. Malluche’s group, using bone histology, has demonstrated that the intact PTH assay has no correlation with bone status in African American ESRD patients.

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    The average level of intact PTH for the African-American with histologically-confirmed adynamic bone disease is the same as the average level of intact PTH for the Caucasian with histologically-confirmed high bone turnover disease. This sets the African-American ESRD patient at particular risk of overdosing with vitamin D, calcium supplements and calcimimetics, leading to adynamic bone disease and soft tissue calcification.

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    Scantibodies Clinical Lab has the new, state-of-the-art assay panel which will allow the pediatric physician to know the ratio for ESRD patients. It also allows the physician to accurately diagnose 94% of adynamic bone disease.

    For even more information regarding the PTH Accuratio 1-84 PTH/7-84 PTH Ratio, please visit our collection of Presentations, Abstracts and References as well as our Glossary of PTH Terminology. Publications documenting the above are on file at Scantibodies and available for your use. Please contact us at this email address for copies: cs@scltesting.com, or fax: 619-596-7674.


    Materials available from Customer Service, or your SCL Sales Representative:

    1. PTH Information Handout Book: "The Opposing Actions of the Two Parathyroid Hormones: 1-84 PTH and 7-84 PTH. Improvement in Renal Bone and Calcium Metabolism Management."
    2. PTH FAQ Booklet
    3. PTH Evidence Binder: A Collection of Journal Articles and the information they provide about PTH and PTH testing, compiled by Dr. Eugene Grochowski, of Johns Hopkins.
    4. Pre-ESRD Presentation Booklet: Mr. Tom Cantor's recent presentation regarding Adynamic Bone Disease and the Pre-ESRD patient. Long and short form booklets available.
    5. Pediatric Presentation Booklet by Dr. Simon Waller, London, England. "Parathyroid Hormone in Children with Chronic Renal Failure". (2003)
    6. "The Ratio of the 2 PTH Hormones: 1-84 PTH and 7-84 PTH, Improvement in Renal Bone and Calcium Metabolism Management."
    7. "Clinical Guidelines" pocket card: laminated card giving the K/DOQI and recommended clinical guidelines for PTH testing.
    8. SCL Directory of Services (content on this site)
    9. Fliers:
      1. The Current Problem with the Use of iPTH or 1-84 PTH Assays Alone
      2. Packing and Shipping Instruction Page
      3. The Clinical Message and Interpretation Guide
      4. Publications Supporting 7-84 PTH (Listing of references)
      5. The Effect of Freeze/Thaw on Whole Blood with Transporting Whole Blood Specimens
      6. SCL Information Guide
      7. Preventing Adynamic Bone Disease
      8. Doctors' Flier re African-American Patients
      9. Patient Flier re African-Americans and PTH testing (available in pads of 50's for waiting rooms).
    10. A-V Materials: (CD Roms, VHS and Audio Cassettes)
      1. Dr. Richard Amerling's Presentation: 2003 ASN with audio.
      2. Dr. Akihide Tokumoto's Presentation: 2003 ASN with audio. Choose English or Japanese.
      3. Bone Biopsy Demonstration DVD -- As performed by Dr. Victor Rozas, Great Lakes Renal Network, Alma, MI.
      4. 3rd Generation Assay for Parathyroid Hormone: Implications for Better Patient Management, Tom Cantor "Industry Speaks" presentation, NKF, 2002.
      5. Dr. Hartmut Malluche: Overview of Renal Osteodystrophy, Vit D and PTH. Seattle Meeting, 2003
      6. Cantor PTH Presentation, GO PTH!July 2004. (Includes latest information regarding bone biopsies and PTH testing.)
      7. Dr. Sharon Moe, The Future of Osteodystrophy Management (Audio Cassette only, 2003)
      8. Dr. Eduardo Slatopolsky: On PTH (VHS Cassette, 2002)
      9. Drs. Martin and Malluche Debate: 2003 (Two CD set)
      10. Charles Gebhart (dialysis patient for 25 years, talks about living with ESRD).

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