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Current immunoassays\u2014categorized into three generations\u2014struggle with PTH\u2019s molecular heterogeneity. Mass spectrometry (MS) offers structural specificity, with recent advances achieving satisfactory sensitivity for intact 1\u201384 PTH quantification and identifying clinically relevant fragments. This review synthesizes the technological limitations of PTH measurement methods, highlights the critical standardization challenges, and discusses evolving strategies, including MS, to pave the way for reliable PTH testing in CKD management.<\/jats:p>","DOI":"10.3389\/fendo.2025.1702206","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:12:47Z","timestamp":1763442767000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Parathyroid hormone assay standardization in CKD-MBD: resolving heterogeneity for precision 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