Abstract
Simple SummaryIn dogs affected with chronic kidney disease (CKD), mineral disorders, including renal hyperparathyroidism (RHPT), are frequent. Secondary RHPT is the increase in serum parathyroid hormone (PTH), that can have a significant impact in the disease progression. Despite its clinical utility, the measurement of serum PTH is not routinely executed due to limited availability of validated methods. The aims of this study were: the analytical validation of a new method for PTH measurement in dogs and analysis of the preliminary association of the obtained results with the renal status. Twenty-seven samples obtained from dogs that were healthy or affected with CKD were analysed. PTH was measured using a commercially available human assay. The precision and accuracy of this method were assessed and the PTH stability at different temperatures was evaluated. Clinical validation was performed by comparing PTH values with clinicopathological parameters often altered during CKD, such as creatinine and phosphorus, and with the disease severity. The method showed an optimal precision and accuracy; the stability was compatible with the standard sample processing times. PTH was positively associated with creatinine and phosphorus. The investigated method was successfully validated in dogs, allowing its use for clinical purposes.Renal hyperparathyroidism (RHPT) is one of the main complications in dogs affected with Chronic Kidney Disease (CKD). The measurement of serum parathyroid hormone (PTH) could be of clinical utility for the disease’s treatment and follow-up; however, PTH is not routinely determined due to limited available methods, often not fully validated in dogs. The aims of this study were the analytical validation of an immunoenzymatic method for the measurement of PTH in canine serum and the analysis of preliminary association of the obtained results with renal function. Twenty-six samples obtained from dogs healthy or affected with CKD were analysed. PTH was measured using a two-site immunoenzymometric human assay (ST AIA-PACK® Intact PTH, Tosoh Bioscience). The analytical validation protocol evaluated the assay precision and accuracy. Also, the PTH’s storage stability at 20 °C, 4 °C and −20 °C was assessed. Clinical validation was performed by comparing PTH values with creatinine, phosphorus and International Renal Interest Society (IRIS) stage. The method showed optimal precision and accuracy, whereas stability was adequate up to 4 h at 20 °C, 24 h at 4 °C and 6 months at −20 °C. PTH was positively associated with creatinine, phosphorus and IRIS stage. The investigated method was thus successfully validated in dogs, allowing its use for clinical purpose.
Highlights
Parathyroid hormone (PTH) is a single chain 84-amino acid polypeptide produced from parathyroid glands and primarily involved in the regulation of circulating ionized calcium concentrations
In patients affected with chronic kidney disease (CKD), serum PTH increases due to a complex pathophysiological mechanism involving phosphorus (P), Fibroblast Growth Factor−23 (FGF-23), vitamin D metabolites and ionized calcium (iCa) [2]
Twenty dogs were included in the study: a total of 5 dogs were healthy, and 15 dogs were affected with different stages of chronic kidney disease: 2 dogs in International Renal Interest Society (IRIS) stage 1, 8 in IRIS stage 2, 4 in IRIS stage 3 and 1 in IRIS stage 4
Summary
Parathyroid hormone (PTH) is a single chain 84-amino acid polypeptide produced from parathyroid glands and primarily involved in the regulation of circulating ionized calcium (iCa) concentrations. Other studies showed the decrease of several vitamin D metabolites in dogs affected with CKD, and a negative correlation between vitamin D metabolites and PTH, FGF-23, and P concentrations, supporting the role of these hormones in the development of RHPT [4,5]. In this scenario the routine measurement of PTH would allow early detection of RHPT; establishment of adequate treatments, such as calcitriol administration; verification of treatments effectiveness; and monitoring of the disease progression. Despite several different assays being reported in published studies, data about their validation are not always exhaustive, as reported below in details [3,4,6,7,8]
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