NDT Advance Access published online on December 1, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm827
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Serum Intact Parathyroid Hormone in Diabetic Patients on Haemodialysis: What is the Treatment Goal?
Unit for Metabolic Medicine, Department of Diabetes and Endocrinology, Cardiovascular Division, King's College London School of Medicine, Guy's Hospital, King's College London, London, UK
Correspondence and offprint requests to: Luigi Gnudi. Unit for Metabolic Medicine, Department of Diabetes and Endocrinology, Cardiovascular Division, King's College London School of Medicine, Guy's Hospital, King's College London, London, UK. Tel: +44-71881939; E-mail: lugi.gnudi@kcl.ac.uk
Keywords: bone osteodystrophy; diabetes; iPTH; vascular disease
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In this issue, Murakami et al. describe an interesting association between intact parathyroid hormone (iPTH) circulating levels and glycaemic control in diabetic patients on haemodialysis [1]. The findings describe an inverse correlation between iPTH serum levels and glycaemic control. Specifically, diabetic patients with poor glycaemic control (HbA1c: 7–8%) are characterized by low circulating iPTH, which is conversely found at higher levels in diabetic patients with good glycaemic control (HbA1c: 5–6%).
Both elevated and low circulating iPTH levels have been linked respectively to high and low bone turnover osteodystrophy (or adynamic bone disease) in patients on haemodialysis [2–6]; despite the fact that iPTH serum levels are considered important for the understanding of the mechanisms leading to renal-related bone disease, changes in