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Revista de Nutrição
On-line version ISSN 1678-9865
PETERS, Bárbara Santarosa Emo; JORGETTI, Vanda and MARTINI, Lígia Araújo. Influence of severe secondary hyperparathyroidism in the nutritional status of patients with chronic renal failure. Rev. Nutr. [online]. 2006, vol.19, n.1, pp. 111-118. ISSN 1678-9865. http://dx.doi.org/10.1590/S1415-52732006000100012.
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.
Keywords : nutritional assessment; renal dialysis; hyperparathyroidism; patients.