Relation of parathyroid hormone with malnutrition in peritoneal dialysis patients

Abstract

Aims: Protein-energy wasting syndrome is a risk factor specific to ESRD is protein-energy wasting (PEW) syndrome. Clinical and experimental studies have suggested that secondary hyperparathyroidism plays a vital role in increasing energy expenditure in patients with ESRD. The geriatric nutritional risk index (GNRI) is used to evaluate nutritional status in various pathological conditions. Considering the effect of parathormone on malnutrition and studies indicating that parathyroid hormone causes weight loss, we aimed to investigate the relationship between malnutrition and parathyroid hormone (PTH) in our patients using GNRI. Methods: Forty-nine patients without known malignancy, liver disease, or chronic inflammatory disease who underwent peritoneal dialysis were included in the study. Patient data were recorded from these files. Height and weight were measured. GNRI was calculated by the formula 14.89 × serum albumin (g/dL) + [41.7 × bodyweight/ideal body weight Results: Forty-nine patients (29 females, 59.2%) were included in the study. Three (6.1%), seven (14.3%), and seven (14.3%) patients had severe, moderate, and mild malnutrition, respectively. GNRI was positively correlated with albumin, hematocrit, and calcium levels (r=0.757, r=0.355, r=0.423; p<0.05, respectively). GNRI was negatively correlated with dialysis vintage (r=-0.303, p=0.038) and PTH (r=-0.287; p=0.046). Conclusion: This study demonstrated a relationship between malnutrition and hyperparathyroidism. Increased PTH levels may cause phenotypic switching from white to brown fat via PTH receptors.

Keywords

• Peritoneal dialysis
• protein-energy malnutrition
• secondary hyperparathyroidism

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