How should the CAP /CIP ratio be considered in prescribing parathyroidectomy?
The CAP /CIP ratio can be useful in predicting bone turnover condition in the ESRD patient with secondary hyperparathyroidism. However, a comprehensive evaluation of the spectrum of clinical indications and laboratory test results should be included before parathyroidectomy is prescribed. The poor renal bone status predictive value of the flawed, 2nd generation “intact” PTH assay should be taken into consideration before being relied upon. For accurate renal bone assessment before parathyroidectomy, a bone biopsy should be considered.
