Abstract
Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. There were no differences in nutritional status and dietary intake between patients with and without SHPT.
Highlights
Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients
Foi realizada por meio de modelo proposto pelo Estudo CANUSA (CANADA-USA: peritoneal dialysis study group),[8] descrito como uma escala de 4 itens e 7 pontos, que permite a classificação em desnutrição grave, leve ou moderada e estado nutricional adequado.[8,21]
Não houve diferenças no estado nutricional e na ingestão alimentar entre os pacientes em diálise peritoneal contínua com e sem HPT2
Summary
Tratou-se um estudo transversal observacional, realizado nas unidades de tratamento dialítico do Hospital Universitário Professor Edgard Santos (HUPES) e da Clínica São Marcos (CSM), Salvador (BA), no período de março a agosto de 2007, envolvendo 74 pacientes. Foram analisados também dados sobre a adequação da terapia dialítica, através do índice de remoção da ureia (KT/V total) e do clearance de creatinina total semanal; assim como alterações do metabolismo mineral e ósseo, através da dosagem de PTH, cálcio e fósforo séricos e do produto cálcio e fósforo. Os níveis séricos de proteína C reativa ultrassensível (PCR US) foram usados como marcadores de inflamação nos pacientes incluídos no estudo. A avaliação da terapia dialítica e dos níveis séricos de PTH, cálcio, fósforo e produto cálcio e fósforo seguiram a técnica e recomendação da National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI).[15,16]. Os pacientes foram submetidos a uma avaliação nutricional, realizada por equipe treinada, que constou de avaliação antropométrica, parâmetros bioquímicos, avaliação subjetiva global (ASG) e consumo alimentar
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