Integrating the treatment of secondary hyperparathyroidism in ESRD
Speaker Dr. Malluche
Blogger: Dr.Azzour Hazzan
Some points from the lecture:1.There are 5 different pth assays assays
2. Have different specificity and sensitivity but the trend is telling and should be trusted.
3.Further using ratio of cap and cip may help (cap is the activating protein within the pth peptide)
4. Using pth you can only screen for high turn over, not diagnose it.
5. Bone volume is also important.
6. Dexa is unreliable and in some cases can give falsely high readings( especially vertebral bones). The hip readings are good
7. Higher bone volume correlates with less calcification in the coronary arteries and vice versa. And that is true with any age.
8. More low turn over with whites along with low volumes
9. More porosis with blacks and high turn over
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