Abstract: TH-PO836
Severe Hyperparathyroidism Is Associated With Nutritional Impairment in Maintenance Hemodialysis Patients
Session Information
- Health Maintenance, Nutrition, Metabolism
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance‚ Nutrition‚ and Metabolism
- 1400 Health Maintenance‚ Nutrition‚ and Metabolism
Author
- Disthabanchong, Sinee, Mahidol University Faculty of Medicine Ramathibodi Hospital Department of Medicine, Bangkok, Bangkok, Thailand
Background
Severe hyperparathyroidism predicts poor outcomes and parathyroidectomy is associated with improved survival in patients with kidney failure. Mechanisms underlying these observations have not been clearly elucidated. The issues regarding nutritional impairment in severe hyperparathyroidism have rarely been addressed. The present study examined nutritional status among maintenance hemodialysis (MHD) patients with different degree of hyperparathyroidism.
Methods
Seven hundred forty-five patients were categorized into four groups according to PTH levels: group 0, PTH<200; group 1, PTH=200-599; group 2, PTH=600-1499; and group 3, PTH≥1500 pg/mL. Group 0 was excluded because low PTH level was linked to older age and malnutrition. Patients in groups 1 and 2 were matched to group 3 by propensity score yielding 410 patients in the final analysis. Nutritional parameters at baseline (Year 0) and the preceding 1 and 2 years (Year -1 and Year -2) were analyzed.
Results
At baseline, lower serum albumin (P<0.001), creatinine (P<0.001), height in female (P=0.001), creatinine/body surface area (Cr/BSA) (P=0.001) and higher number of patients with serum albumin <38 g/L (P<0.001) were observed in group 3 compared to groups 1 and 2. Higher PTH level was independently associated with serum albumin <38 g/L (P<0.001) and serum Cr/BSA <380 μmol/L/m2 (P=0.001). Lower serum albumin, creatinine and Cr/BSA and higher number of patients with serum albumin <38 g/L were observed at Year 0 compared to Year -1 and Year -2 among patients in group 3. Between group comparisons confirmed a significant difference in serum albumin, the number of patients with serum albumin <38 g/L, serum creatinine and Cr/BSA between baseline and the preceding 1 and 2 years in group 3 compared to groups 1 and 2. The number of patients with Cr/BSA <380 μmol/L/m2 was also significantly different between baseline and the preceding 1 and 2 years in group 3 compared to group 1. Weight loss was more substantial in group 3 compared to group 2 (P=0.03) and the number of patients with ≥5% weight loss was higher in group 3 compared to groups 1 (P=0.005) and 2 (P=0.03).
Conclusion
MHD patients with severe hyperparathyroidism had deterioration of nutritional status compared to patients with moderate hyperparathyroidism and patients with PTH level within the recommended range.