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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Interpretation of serum parathyroid hormone concentrations in dialysis patients: what do the KDIGO guidelines change for the clinical laboratory?

Jean-Claude Souberbielle1 / Etienne Cavalier2 / Guillaume Jean3

1Laboratoire d'Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, Paris, France and Université Paris Descartes, INSERM U845, Paris, France

2Department of Clinical Chemistry, University of Liège, University Hospital of Liège, Liège, Belgium

3Centre de Rein Artificiel, Tassin la Demi-lune, France

Corresponding author: Jean-Claude Souberbielle, Laboratoire d'Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France and Université Paris Descartes, INSERM U845, Paris, France

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 6, Pages 769–774, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.157, March 2010

Publication History

Published Online:


The Kidney Disease: Improving Global Outcomes (KDIGO) have recently replaced the K/DOQI guidelines to help nephrologists in diagnosing, treating and monitoring chronic kidney disease mineral and bone disorders (CKD-MBD). Here, we comment on the KDIGO recommendations concerning the interpretation of parathyroid hormone (PTH) concentrations in dialysis patients: “In patients with CKD stage 5D, we suggest maintaining iPTH in the range of approximately two to nine times the upper normal limit of the assay. We suggest that marked changes in PTH concentrations in either direction within this range prompt an initiation or change in therapy to avoid progression to concentrations outside of this range”. Our comments concern the interpretation of PTH in dialysis patients, but also the more global problem of establishing normal values for PTH.

Clin Chem Lab Med 2010;48:769–74.

Keywords: chronic kidney disease; clinical guidelines; dialysis; parathyroid hormone; reference values

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