PTH Measurement in Clinical Laboratories

In this chapter, we will start with a review of the methodological evolution of the clinical parathyroid hormone (PTH) assays, follow with a detailed discussion of clinical utility, analytical and clinical performances of the current second and third generation assays, their drawbacks and the efforts taken collaboratively by academia and industry to harmonize the PTH assays. Next, we will focus on the profiling of various forms of circulating PTH in healthy and diseases by LC-MS/MS-based analysis, which greatly contribute to the advancement of our understanding in the structure/function and pathophysiology of PTH over the past three decades. Finally, we will comment on the remaining challenges of the present PTH assays for patient management and point to the future research and development needs to meet the unmet medical needs in managing patients with hyperparathyroidism and chronic kidney diseases–mineral and bone disorder (CKD-MBD)