| [ Summary ] |
The exact endpoint of PTH levels in any treatment of HD patients is still controversial. The underlying reasons of this seem to be as follows; (1) very little consensus on the interpretations of PTH, (2) variations in appropriate PTH levels for normal bone mineral turnover by individuals (i. e. skeletal resistance against PTH), (3) weak evidence that the endpoint of PTH can be decided on only from bone metabolism. Therefore, in order to compensate for difficulties with PTH interpretation, various parameters for bone metabolism, imaging studies (including radiology), ultrasounds and scintigrams, as well as bone biopsies, should be incorporated for the total evaluation of skeletal pathology of dialysis patients. Furthermore, each parathyroid hormone assay may need to be identified and evaluated independently when we analyze the bone metabolism of dialysis patients. |