What CAP /CIP ratio can be considered pathological?
In the clinical management of mineral metabolism disorders for the ESRD patient, it is clear that one of the most life-threatening conditions to avoid and address is adynamic low bone turnover disease, since this disease may contribute to soft tissue and vascular calcification. One of the greatest advances of the CAP /CIP ratio over the flawed 2nd generation “intact” PTH assay is the ability to identify, without bone biopsy, adynamic low bone turnover disease in the ESRD patient, even if the patient has a high “intact” PTH value. Based on published bone histomorphological evidence, a ratio of less than one in an untreated ESRD patient can be used to predict adynamic low bone turnover disease. (ref. Monier-Faugere, Malluche, et.
