American Journal of Medical and Biological Research

Current Issue» Volume 2, Number 4 (2014)

Article

Presepsin: A Novel and Potential Diagnostic Biomarker for Sepsis

1Department of Microbiology, Prathima Institute of Medical sciences, Karimnagar, India

2Department of Biochemistry, Vydehi Institute of Medical sciences and Research center, Bengaluru, India

3Department of Biochemistry, Chalmeda Anandarao Institute of Medical sciences, Karimnagar, India

4Department of General Medicine, Vydehi Institute of Medical sciences and Research center, Bengaluru, India

5Department of Dermatology, Vydehi Institute of Medical sciences and Research center, Bengaluru, India


American Journal of Medical and Biological Research. 2014, 2(4), 97-100
DOI: 10.12691/ajmbr-2-4-3
Copyright © 2014 Science and Education Publishing

Cite this paper:
K V Ramana, Venkata BharatKumar Pinnelli, Sabitha Kandi, Asha G, Jayashankar CA, Bhanuprakash, Raghavendra DS, Sanjeev D rao. Presepsin: A Novel and Potential Diagnostic Biomarker for Sepsis. American Journal of Medical and Biological Research. 2014; 2(4):97-100. doi: 10.12691/ajmbr-2-4-3.

Correspondence to: K  V Ramana, Department of Microbiology, Prathima Institute of Medical sciences, Karimnagar, India. Email: ramana_20021@rediffmail.com

Abstract

Sepsis is a potential clinical condition which is a consequence of infectious disease or a severe inflammatory reaction secondary to infection or injury. Sepsis in Greek means putrefaction or decay, correlating well with the multiple organ failure and severe shock resulting in death of the patient suffering from severe sepsis. Clinical management of sepsis requires prompt laboratory diagnosis and formulation of effective patient management strategies that may include antimicrobial chemotherapy in case of sepsis induced by infectious microbe. Although many laboratory biomarkers are available for the diagnosis of sepsis, only few markers have proven to be beneficial in differentiating infectious disease sepsis and sepsis of non-infectious origin. Of the available markers only few have prognostic value. We in this review discuss the utility of a novel and emerging sepsis marker, the presepsin which has a better diagnostic and prognostic value, and has been effective in predicting the survival of the sepsis patients.

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References

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[1]  Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 2008; 34: 17-60.global death.
 
[2]  Dupuy, F. Philippart, Y. Pean et al., “Role of biomarkers in the management of antibiotic therapy: an expert panel review. I: currently available biomarkers for clinical use in acute infections,” Annals of Intensive Care, vol. 3, no. 22, article 1, 2013.
 
[3]  Wu HP, Chen CK, Chung K, Jiang BY, Yu TJ, Chuang DY. Plasma transforming growth factor-b1 level in patients with severe community-acquired pneumonia and association with disease severity. J Formos Med Assoc 2009; 108: 20-27.
 
[4]  Guignant C, Voirin N, Venet F, Poitevin F, Malcus C, Bohé J, et al. Assessment of pro-vasopressin and pro-adrenomedullin as predictors of 28-day mortality in septic shock patients. Intensive Care Med 2009; 35: 1859-1867.
 
[5]  J. P. Hinson, S. Kapas, and D. M. Smith, “Adrenomedullin, a multifunctional regulatory peptide, “Endocrine Reviews, vol. 21, no. 2, pp. 138-167, 2000.
 
Show More References
[6]  Seligman R, Papassotiriou J, Morgenthaler NG, Meisner M, Teixeira PJ. Prognostic value of midregional pro-atrial natriuretic peptide in ventilator-associated pneumonia. Intensive Care Med 2008; 34: 2084-2091.
 
[7]  Y. Wu, F. Wang, X. Fan et al., “Accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients: a systematic review and meta-analysis,” Critical Care, vol. 16, no. 6, article R229, 2012.
 
[8]  Y. Backes, K. van der Sluijs, D. Mackie et al., “Usefulness of suPAR as a biological marker in patients with systemic inflammation or infection: a systematic review Intensive,” Care Medicine, vol. 38, no. 9, pp. 1418-1428, 2012.
 
[9]  N. Hofer, E. Zacharias, W. Müller, and B. Resch, “An update on the use of C-reactive protein in early-onset neonatal sepsis: current insights and new tasks,” Neonatology, vol. 102, no. 1, pp. 25-36, 2012.
 
[10]  Longo Dan. Harrison's principles of internal medicine. New York: McGraw-Hill, 2011: 271 millions death.
 
[11]  Qi Zou, Wei Wen, Xin-chao Zhang. Presepsin as a novel sepsis biomarker. World J Emerg Med 2014; 5 (1): 16-19.
 
[12]  Cesar Henriquez-Camacho and Juan Losa, “Biomarkers for Sepsis,” BioMed Research International, vol. 2014, Article ID 547818, 6 pages, 2014.
 
[13]  D. W. Bates, K. Sands, E. Miller et al., “Predicting bacteremia in patients with sepsis syndrome. Academic Medical Center Consortium Sepsis Project Working Group,” Journal of Infectious Diseases, vol. 176, no. 6, pp. 1538-1551, 1997.
 
[14]  P. Hausfater. Biomarkers and infection in the emergency unit. Médecine et Maladies Infectieuses Volume 44, Issue 4, April 2014, Pages 139-145.
 
[15]  Elisa Pizzolato, Marco Ulla, Claudia Galluzzo, Manuela Lucchiari. Tilde Manetta, Enrico Lupia et al. Role of presepsin for the evaluation of sepsis in the emergency department. Clinical Chemistry and Laboratory Medicine (CCLM). Volume 0, Issue 0, ISSN (Online) 1437-4331.
 
[16]  Ulla et al.: Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study. Critical Care 2013 17: R168.
 
[17]  Mussap M, Noto A, Fravega M, Fanos V: Soluble CD14 subtype presepsin (sCD14-ST) and lipopolysaccharide binding protein (LBP) in neonatal sepsis: new clinical and analytical perspectives for two old biomarkers. J Matern Fetal Neonatal Med 2011, 24(Suppl 2): 12-14.
 
[18]  Mussap M, Puxeddu E, Burrai P, Noto A, Cibecchini F, Testa M, Puddu M, Ottonello G, Dessì A, Irmesi R, Gassa ED, Fanni C, Fanos V: Soluble CD14 subtype (sCD14-ST) presepsin in critically ill preterm newborns: preliminary reference ranges. J Matern Fetal Neonatal Med 2012, 25(Suppl 5):51-53.
 
[19]  Palmiere C, Mussap M, Bardy D, Cibecchini F, Mangin P: Diagnostic value of soluble CD14 subtype (sCD14-ST) presepsin for the postmortem diagnosis of sepsis-related fatalities. Int J Legal Med 2013, 127:799-808.
 
[20]  Masson et al.: Presepsin (soluble CD14subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian outcome sepsis trial. Critical Care 2014; 18: R6.
 
[21]  Valeria Sargentini, Giancarlo Ceccarelli, Mariadomenica D’Alessandro, Daniela Collepardo, Andrea Morelli, Annalia D’Egidio et al. Presepsin as a potential marker for bacterial infection relapse in critical care patients. A preliminary study. Clinical Chemistry and Laboratory Medicine (CCLM). Volume 0, Issue 0, ISSN (Online) 1437-4331.
 
[22]  Luis García de Guadiana Romualdo, Patricia Esteban Torrella, Monserrat Viqueira González, Roberto Jiménez Sánchez, Ana Hernando Holgado, Alejandro Ortín Freire et al. Diagnostic accuracy of presepsin (soluble CD14 subtype) for prediction of bacteremia in patients with systemic inflammatory response syndrome in the Emergency Department. Clinical Biochemistry Volume 47, Issues 7-8, May 2014, Pages 505-508.
 
[23]  Endo S, Suzuki Y, Takahashi G, Shozushima T, Ishikura H, Murai A et al. U sefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study. J Infect Chemother. 2012 Dec; 18(6): 891-7.
 
[24]  Filippo Mearelli et al. Procalcitonin, presepsin, pro-adrenomedullin, fibrin degradation products, and lactate in early diagnosis and prognosis of septic patients newly admitted to the intermediate care unit from the emergency department. Critical Care 2013, 17(Suppl 4):P17.
 
[25]  Tatjana Vodnik, Goran Kaljevic, Tanja Tadic, Nada Majkic-Singh. Presepsin (sCD14-ST) in preoperative diagnosis of abdominal sepsis. Clinical Chemistry and Laboratory Medicine. Volume 51, Issue 10, Pages 2053-2062.
 
[26]  Özlem Çakır Madenci, Sezer Yakupoğlu, Nur Benzonana, Nihal Yücel, Derya Akbaba, Asuman Orçun Kaptanağası. Evaluation of soluble CD14 subtype (presepsin) in burn sepsis. Burns Volume 40, Issue 4, June 2014, Pages 664-669.
 
[27]  Oh Joo Kweon, Jee-Hye Choi, Sang Kil Park, Ae Ja Park. Usefulness of presepsin (sCD14 subtype) measurements as a new marker for the diagnosis and prediction of disease severity of sepsis in the Korean population. Journal of Critical Care Available online 21 June 2014.
 
[28]  Shigeatsu Endo, Yasushi Suzuki, Gaku Takahashi, Tatsuyori Shozushima, Hiroyasu Ishikura, Akira Murai. Presepsin as a powerful monitoring tool for the prognosis and treatment of sepsis: A multicenter prospective study. Journal of Infection and Chemotherapy Volume 20, Issue 1, January 2014, Pages 30-34.
 
[29]  Novelli, G, Morabito, V, Ferretti, G., Pugliese, F, Ruberto, F, Rossi, M et al. PATHFAST Presepsin assay for early diagnosis of bacterial infections in surgical patients. Preliminary study.: 423 Transplantation: 27 November 2012 - Volume 94 - Issue 10S - p 532.
 
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Article

Some Viral Sero-Markers of Patients with Abnormally Raised Total Bile Acid Receiving Treatments in Herbal/Traditional Homes of Some Rural Communities in Nigeria

1Department of Medical Laboratory Science, Achievers University Owo -Nigeria


American Journal of Medical and Biological Research. 2014, 2(4), 91-96
DOI: 10.12691/ajmbr-2-4-2
Copyright © 2014 Science and Education Publishing

Cite this paper:
Mathew Folaranmi OLANIYAN. Some Viral Sero-Markers of Patients with Abnormally Raised Total Bile Acid Receiving Treatments in Herbal/Traditional Homes of Some Rural Communities in Nigeria. American Journal of Medical and Biological Research. 2014; 2(4):91-96. doi: 10.12691/ajmbr-2-4-2.

Correspondence to: Mathew  Folaranmi OLANIYAN, Department of Medical Laboratory Science, Achievers University Owo -Nigeria. Email: olaniyanmat@yahoo.com

Abstract

Background to the Study: Blind therapeutic management is a common feature of the traditional management of clinical cases that may obscure immunochemical and biochemical abnormalities such as viral infections and abnormally raised total bile acid () which may make treatments unsuccessful. Aim and Objective: This work was designed to determine some viral markers of patients with abnormally raised Total Bile Acid receiving treatments in herbal/traditional homes of some rural communities in Nigeria. Materials and Method: Fifty one (51(25.1%)) of 203 patients aged 21-52 years in Saki-East, Saki-West and ATISBO with abnormally raised total bile acid under going treatment in 15 herbal homes of Saki-East, Saki-West and ATISBO Local Government areas at the Northern part of Oyo state – Nigeria between January and June, 2014 were studied. Thirty two (32(21.3%)) out one hundred and fifty (150) age-matched patients with abnormally raised visiting five (5) orthodox hospitals were also studied within the same period. 139(92.7%) with normal out of 150 apparently healthy individuals aged 20-55 years initially selected were studied as normal control subjects. Immuno assays were carried out on the subjects by Immunoblotting and ELIZA while fasting plasma was estimated in the subjects biochemically. Results: There was a lower incidence of positive 6.3%(2)ant-HIV, 15.6%(5) anti-HCV antibodies and 25%(8) HBsAg in patients receiving treatment in orthodox hospitals with a mean plasma of 16±2.0 µmol/L than patients receiving treatment in Herbal homes 7.8%(4) positive anti-HIV, 17.6%(9) anti-HCV and 31.4%(16) HBsAg obtained in with a mean plasma of 18±3.2 µmol/L. There was also a lower prevalence of positive 3.6%(5) anti-HIV, 4.3%(6) anti-HCV and 7.2%(10) HBsAg with a plasma of 6.5±0.3 µmol/L in the normal control subjects than the results obtained from the patients receiving treatments from both orthodox and traditional/herbal homes.. The immunochemical status of the subjects also revealed evidence of viral co-infections as 2%(1) anti-HIV + anti-HCV in patients receiving treatments in herbal homes, 3.1%(1) anti-HIV + HBsAg in patients receiving treatments in orthodox hospitals with a mean plasma of 16±2.0 µmol/L and 5.9%(3) anti-HIV + HBsAg in patients receiving treatments in herbal homes with a mean plasma of 18±3.2 µmol/L. There was a significantly higher difference in the mean plasma value of TBA and the prevalence of the viral markers including coinfections in the patients receiving treatment in orthodox hospitals and in the patients receiving treatments in herbal homes than the results obtained from the normal control with p< 0.05. There was also a significantly higher prevalence of the viral markers including coinfections in the patients of herbal homes than the resulusts obtained in the patients of orthodox hospitals and the normal control subjects (p<0.05).The frequency of the abnormally raised TBA, of the patients visiting herbal homes, orthodox hospitals and that of the apparently healthy individuals was 51(25.1%)), 32(21.3%) and 11(7.3%) respectively. Conclusion: The incidence of positive HBsAg, anti-HIV, anti-HCV antibodies increases with increase in Total Bile Acids considering the mean concentration of the parameter and the pattern of the viral markers in the subjects and are more prevalent in patients receiving treatments from herbal homes than those attending orthodox hospitals and the control subjects. Evaluation of Viral markers of patients with abnormally raised Total Bile Acid is recommended for effective management of this biochemical abnormality in herbal homes.

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References

[[[[[[[[[[[[
[1]  Stanley, Bob. “Recognition and Respect for African Traditional Medicine”. 2004: Canada's International Development Research Centre. Retrieved 11 March 2010.
 
[2]  Job Isaac Jondiko Ogoche. Toward a clinical research framework for collaboration among selected stakeholders in traditional herbal medical practice in seme and gem sub-locations in Nyanza province, Kenya. : Vol. 8 (3), pp. 144-157, 17 January, 2014. Academic Journals http://www.academicjournals.org/JMPR
 
[3]  Ekeanyanwu Chukwuma Raphael. Traditional Medicine in Nigeria: Current Status and the Future. Research Journal of Pharmacology, 5: 90-94. 2011.
 
[4]  Odugbemi T. A. Textbook of Medicinal Plants from Nigeria: Lagos, University of Lagos Press. 2008
 
[5]  Mokaila, Aone. “Traditional Vs. Western Medicine-African Context”. Drury University, Springfield, Missouri 2001. Retrieved 11 March 2010.
 
Show More References
[6]  Helwig, David. “Traditional African medicine”. 2010: Encyclopedia of Alternative Medicine. Retrieved 4 Feb 2010.
 
[7]  Shaw-Stiffel T. A., “Chronic hepatitis,” in Principles and Practice of Infectious Diseases, G. L. Mandell, J. E. Bennett, R. Dolin, et al., Eds., pp. 1297-1321, Churchill Livingstone, New York, NY, USA, 5th edition, 2000.
 
[8]  Russell DW. “The enzymes, regulation, and genetics of bile acid synthesis”. Annu. Rev. Biochem.: 72: 137-74. 2003. PMID 12543708.
 
[9]  Chiang JY. “Bile acids: regulation of synthesis”. J. Lipid Res.: 50 (10): 1955-66. 2009. PMC 2739756. PMID 19346330.
 
[10]  K.P. Osemene, A.A. Elujoba and M.O. Ilori A Comparative Assessment of Herbal and Orthodox Medicines in Nigeria Research Journal of Medical Sciences: Volume 5 Issue 5, 280-285. 2011.
 
[11]  Simon O. Obi, Haruna A. Baba, Marycelin M. Baba, Grace I. Amilo and Alhaji Bukar. The Effect of Co-infection of HIV and Hepatotropic Viruses on Selected Biochemical and Haematological Markers of Patients in Northeastern Nigeria. International Journal of Tropical Disease & Health: 4 (5): 2014 SCIENCEDOMAIN international www.sciencedomain.org
 
[12]  Ballah AB, Ajayi B, Abja AU, Bukar AA, Akawu C, Ekong E. A survey of hepatitis B and C virus prevalence in HIV positive patients in a tertiary health institution in North Eastern Nigeria. International of Medicine and Medical Science.; 4 (1): 13-18.2012
 
[13]  Ibeh BO, OluOmodamiro OD, Ibeh U and Habu JB. Biochemical and haematological changes in HIV subjects receiving Winnie cure antiretroviral drug in Nigeria. Journal of Biomedical Science.; 20: 73. 2013.
 
[14]  Adeneye, A.A., Agbaje, E.O., Pharmacological evaluation of oral hypoglycemic and Antidiabetic effects of fresh leaves ethanol extract of Morinda lucida benth. in normal and alloxan-induced diabetic rats. Afr J. Biomed Res.,: 11: 65-71.2008
 
[15]  Anofi, O.T.A., Olugbenga, O.O. Toxicological evaluation of Ethanolic root extract of Morinda lucida (L.) Benth (Rubiaceae) in male Wistar rats. J. Natural Pharmaceuticals,: 2 (2): 108-114. 2011
 
[16]  Otegbayo JA1, Taiwo BO, Akingbola TS, Odaibo GN, Adedapo KS, Penugonda S, Adewole IF, Olaleye DO, Murphy R, Kanki P. Prevalence of hepatitis B and C seropositivity in a Nigerian cohort of HIV-infected patients. Ann Hepatol.: Apr-Jun; 7 (2): 152-6. 2008.
 
[17]  Abbas, A., Lichtman, A., &Pillai, S. Basic immunology Functions and Disorders of the Immune System. 2012; (4th ed., p. 40). Philadelphia, PA: Saunders/Elsevier.
 
Show Less References

Article

The Set Point of Intact Parathyroid Hormone-Ionized Calcium Curve during the Progression of Secondary Hyperparathyroidism among Patients Undergoing Haemodialysis

1Department of Biochemistry, HOD lab in-charge, Apollo Reach Hospital, Karimnagar, Andhra Pradesh

2Department of Biochemistry, Chalmeda Anadrao Institute of Medical Sciences, Karimnagar

3Department of Biochemistry, Prathima Institute of Medical Sciences, Karimnagar


American Journal of Medical and Biological Research. 2014, 2(4), 87-90
DOI: 10.12691/ajmbr-2-4-1
Copyright © 2014 Science and Education Publishing

Cite this paper:
T Sudhakar, Sabitha Kandi, B venugopal, K. Bhagwan Reddy, K. V. Ramana. The Set Point of Intact Parathyroid Hormone-Ionized Calcium Curve during the Progression of Secondary Hyperparathyroidism among Patients Undergoing Haemodialysis. American Journal of Medical and Biological Research. 2014; 2(4):87-90. doi: 10.12691/ajmbr-2-4-1.

Correspondence to: K.  V. Ramana, Department of Biochemistry, Prathima Institute of Medical Sciences, Karimnagar. Email: ramana_20021@rediffmail.com

Abstract

The parathyroid gland secretes parathyroid hormone (PTH) which is a key element in the regulation of serum calcium. The PTH elevates serum calcium activities by regulating its action on the bones, kidneys and small intestine. The set point of PTH secretion defines the sensitivity of the parathyroid glands to calcium concentration. Secondary hyperparathyroidism (SHPT) is a common complication of end stage renal disease (ESRD). Ionized calcium is physiologically active form of calcium status of the body and is used for accurately monitoring calcium status in renal diseases. The present study states that the ionized calcium is the set point of secondary hyperparathyroidism undergoing haemodialysis and the range of set point lies between 2.3 – 4.8 mg/dl (0.57 – 1.2 mmol/L). The status of iPTH, set point are frequently monitored in subtotal hyperparathyroidectomy where imaging studies are not beneficial (anatomically situated on postero-lateral surface of thyroid gland) to know the appearance of parathyroid gland.

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References

[[[[[[[[[[[[[[[[[[[[[[[[[[[[[
[1]  Brown EM. Extracellular ca+2 sensing, regulation of parathyroid cell function, and role of ca+2 and other ions as extracellular (first) messengers. Physiol Rev. 1991: 71; 371-411.
 
[2]  Brown EM and Macleod RJ. Extracellular calcium sensing and extracellular calcium signaling. Physiol Rev. 2001:81; 239-297.
 
[3]  Silver J, Kilav R & Naveh-Many T. Mechanisms of secondary hyperparathyroidism. American Journal of Physiology. 2002: 23: F367-F376.
 
[4]  Brown EM, Gamba G, Riccardi D et al. Cloning and characterization of an extracellular ca+2 -sensing receptor from bovine parathyroid. Nature. 1993: 366: 575-80. [pub med]
 
[5]  Chattopadhyay N, Mothal A, Brown EM. The calcium-sensing receptor: Window into the physiology and pathophysiology of mineral ion metabolism. Endocr Rev. 1996; 17: 289-307.
 
Show More References
[6]  Saidak Z, Mentaverri R, Brown EM. The role of the calcium-sensing receptor in the development and progression of cancer. Endocr Rev. 2009; 30: 178-95. [pub med]
 
[7]  Kifor O, Moore FD Jr, Wang P, Goldstein M, Vassilev P et al.,. Reduced immunostaining for the extracellular ca+2 sensing receptor in primary and uremic secondary hyperparathyroidism. J Clin Endocrinol Metab. 1996;81: 1598-1606. [pub med]
 
[8]  Gogusev J, Duchambon P, Hory B, Giovannini M, Goureau Y et al.,. Depressed expression of calcium receptor in parathyroid gland tissue of patients with hyperparathyroidism. Kidney Int. 1997; 51: 328-36. [pub med]
 
[9]  Mathias RS, Nguyen HT, Zhang MY, Portole AA. Reduced expression of the renal calcium-sensing receptor in rats with experimental chronic renal insufficiency. J Am Soc Nephrol. 1998; 9: 2067-74. [pub med]
 
[10]  C.E.Duran, Jose Vicente Torregrosa, Y. ALmaden, A. Canalejo, J. M.Campistol et al.,. Dynamics of calcium-regulated PTH secretion in secondary hyperparathyroidism: comparison between invivo Vs invitro responses. Nefrologia 2010; 30 (1); 73-77.
 
[11]  Felsenfeld AJ, Llach F. Parathyroid gland function in chronic renal failure. Kidney Int 1993; 43: 771-89. [pub med]
 
[12]  Felsenfeld AJ, Rodriguez M. The set point of calcium. Another view. Nephrol Dial Transplant. 1996;11: 1722-5.[pub med]
 
[13]  Goodman W, Salusky IB. Parathyroid gland function and the set point for PTH release: understanding the available data. Nephrol Dial Transplant. 1996:11: 16-8. [pub med]
 
[14]  Parofitt AM. Relation between parathyroid cell mass and plasma calcium concentration in normal and uremic subjects. Arch Intern Med. 1969; 124: 269-73. [pub med]
 
[15]  Felsenfeld AJ, Rodriguez M, Aguilera-Tejero E. Dynamics of parathyroid hormone secretion in Health and secondary hyperparathyroidism. Clin J Am Soc Nephrol. 2007: 2: 1283-305. [pub med]
 
[16]  Buritt MF, Picrides AM. Comparative studies of total and ionized calcium in serum in normal subjects and patients with renal disorders. Mayo Clin Prac 1980; 55: 606-13.
 
[17]  Gidenne S, Vigezzi JF, Delacour H, Damiano J, Clerc Y. Direct determination or estimated value of plasma ionized calcium: indications and limits. Ann Biol Clin (Paris). 2003: 61 (4): 393-9.
 
[18]  Robertson WG. Measuremenr of ionized calcium in body fluids-a review. Ann Clin Biochem. 1976; 13 (6): 540-8.
 
[19]  Soong WJ, Wang HZ, Hwang B. Heparinization of blood decreases ionized calcium concentration. Zhonghua Yi Xue Za Zhi (Taipei). 1991; 47 (5): 331-5.
 
[20]  Brown EM, Wilkson RE, Eastman RC, Pallota J & Marynick SP. Abnormal regulation of parathyroid hormone release by calcium in secondary hyperparathyroidism due to chronic renal failure. Journal of Clinical Endocrinology and Metabolism. 1993; 76: 1489-94.
 
[21]  Ramirez JA, Goodman WG, Gornbein J, Menezes C, Moulton L et al.,. Direct invivo comparison of calcium-regulated parathyroid hormone secretion in normal volunteers and patients with secondary hyperparathyroidism. Journal of clinical Endocrinology and Metabolism. 1993; 76: 1489-94.
 
[22]  Goodman WG, Belin T, Gales B, Juppner H, Segre GV et al.,. Calcium regulated parathyroid hormone release in patients with mild or advanced secondary hyperparathyroidism. Kidney International. 1995; 48: 1553-1558.
 
[23]  Malberti F, Corradi B, Pagliari, Romanini D, Gazo A, et al.,. The sigmoidal parathyroid hormone-ionized calcium curve and the set point of calcium in hemodialysis and continuous ambulatory peritoneal dialysis. Peritoneal Dialysis International. 1993; 13: (suppl 2): S476-S479.
 
[24]  Goodman WG, Veldhuis JD, Belin TR, Van Herle AJ, Juppner H at al.,. Calcium sensing by parathyroid glands in secondary hyperparathyroidism. Journal of clinical Endocrinology & Metabolism. 1998: 83: 2765-72.
 
[25]  Borrego MJ, Felsenfeld AJ, Martin-Malo A, Almaden Y, Concepcion MT et al.,. Evidence for adaptation of the entire PTH-calcium curve to sustained changes in the serum calcium in hemodialysis patients. Nephrology Dialysis and Transplantation. 1997; 12: 505-513.
 
[26]  Cardinal H, Brossard JH, Roy L, Lepage R, Rousseau L & D’Amour P. the setpoint of parathyroid hormone stimulation by calcium is normal in progressive renal failure. Journal of clinical Endocrinology and Metabolism. 1998; 83: 3839-3844.
 
[27]  Ritter CS, Finch JL, Slatopolsky EA & Brown AJ. Parathyroid hyperplasia in uremic rats precedes down-regulation of the calcium receptor. Kidney International. 2001; 60: 1737-44.
 
[28]  Carling T, Rastad J, Szabo E, Westin G & Akerstrom G. Reduced parathyroid vitamin D receptor messenger ribonucleic acid levels in primary and secondary hyperparathyroidism. Journal of Clinical Endocrinology and Metabolism. 2000; 85: 2000-2003.
 
[29]  Lewin E, Garfia B, Recio FL, Rodriguez M & Olgaard K. Persistent downregulation of calcium-sensing receptor mRNA in rat parathyroids when severe secondary hyperparathyroidism is reversed by isogenic kidney transplantation. Journal of the American Society of Nephrology. 2002; 13: 2110-2116.
 
[30]  Pahl M, Jara A, Bover J, Rodriguez M & Felsenfeld AJ. The set point of calcium and the reduction of parathyroid hormone in hemodialysis patients. Kidney Interrnational. 1996; 49: 226-231.
 
[31]  Rodriguez M, Caravaca F, Fernandez E, Borrego MJ, Lorenzo V et al.,. Evidence for both abnormal set point of PTH stimulation by calcium and adaptation to serum calcium in hemodialysis patients with hyperparathyroidism. Journal of bone and mineral research. 1997: 12: 347-355.
 
[32]  Hardy-Yverneau P, Shenouda M, Moriniere P, Lagallais C, Brazier M et al.,. The dependency of calcium set point on basal plasma calcium in dialysis patients: a better explanation for the discrepancies regarding its link with PTH secretion than methodological differences. Clinical Nephrology. 1998; 50: 236-246.
 
[33]  Malberti F, Farina M & Imbasciati E. The PTH-Calcium curve and the set point of calcium in primary and secondary hyperparathyroidism. Nephrology Dialysis and Transplantation. 1999; 14: 2398-2406.
 
[34]  Rodriguez M, Caravaca F, Fernandez E, Borrego MJ, Lorenzo V et al. Evidence for both abnormal set point of PTH stimulation by calcium and adaptation to serum calcium in hemodialysis patients with hyperparathyroidism. Journal of Bone and Mineral Research. 1997:12:347-355.
 
Show Less References