Influence of severe secondary hyperparathyroidism in the nutritional status of patients with chronic renal failure
Keywords:
nutritional assessment, renal dialysis, hyperparathyroidism, patientsAbstract
Objective
To evaluate parathyroid hormone effects in the nutritional status of hemodialysis patients with secondary
hyperparathyroidism.
Methods
Twenty-six adult patients with a mean age of 47 ± 8 years were evaluated. The patients were divided into two
groups according to their levels of parathyroid hormone and matched for gender. Patients in group 1 (n=13)
presented parathyroid hormone levels above 300pg/ml (1486 ± 920pg/ml) and patients in group 2 (n=13)
below 300pg/ml (199.8 ± 122.2pg/ml). The following parameters were also assessed: 3-day food diaries,
anthropometric data and biochemical markers of bone metabolism.
Results
Group 1 presented significantly lower body mass index, midarm muscle circumference, skinfold thickness and
body fat compared with patients from group 2 (p<0.05). There was a negative and significant correlation
between parathyroid hormone and total body fat (r=-0.6; p<0.05). In addition, in the multiple regression
analysis, the parathyroid hormone and the time in hemodialysis explain in 42% the decrease in total body fat.
Concerning nutrient intakes and biochemical markers, except for parathyroid hormone, there was no statistically
significant difference between the two groups. All patients presented lower energy, protein and calcium
intakes than those recommended for dialysis patients. Phosphorus intake was 11±.6 and 15±5mg/kg/day for
groups 1 and 2, respectively, values considered adequate for this population.
Conclusion
In conclusion, elevated levels of parathyroid hormone and time in hemodialysis have a negative effect on total
body fat and can influence the nutritional status of chronic renal failure patients.
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