[Determining the diagnostic value of alkaline phosphatase in comparison with parathyroid hormone [PTH] of renal osteodystrophy for treatment with calcitriol in hemodialysis patients]

ABSTRACT

Serum parathyroid hormone [PTH] is one of the most important tests for treatment of hemodialysis patients with calcitriol. This drug should be started when the PTH >/= 200 pg/ml. However, the appropriate level of serum alkaline phosphates [ALP] for starting calcitriol is unclear. The aim of this study was to determine serum ALP as cutoff point for treatment of secondary hyperparathyroidism with calcitriol. This study was a cross sectional. The serum level of PTH and ALP were measured in 75 chronic hemodialysis patients. The correlation between PTH and ALP in diagnosis for treatment with calcitriol was significant [Kappa test P-Value=0.000]. In determination of diagnostic value of ALP [at level 300IU/L] for treatment with calcitriol, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 88.9%, 93.9%, 66.7%, 98.4% and 93.3%, respectively. The cutoff point of ALP for treatment with calcitriol was 300IU/L [normal 100-290IU/L]. These findings suggest that serum ALP is a good test for treatment of secondary hyperparathyroidism. The results also indicate that calcitriol administration should not be started with ALP<300 IU/L