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Body composition changes in haemodialysis patients with secondary hyperparathyroidism after parathyroidectomy measured by conventional and vector bioimpedance analysis

Published online by Cambridge University Press:  08 March 2007

B. S. E. Peters ,
V. Jorgetti  and
L. A. Martini
B. S. E. Peters
Affiliation:
Nutrition Department, School of Public Health, Sao Paulo University, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01 246-904, São Paulo, Brazil
V. Jorgetti
Affiliation:
Nephrology Department, Medicine School, Sao Paulo University, Av. Dr. Arnaldo, 455, Cerqueira César, CEP 01 246-903, São PauloBrazil
L. A. Martini*
Affiliation:
Nutrition Department, School of Public Health, Sao Paulo University, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01 246-904, São Paulo, Brazil
*
*corresponding author: Dr Lígia Arau'jo Martini, fax +55 11 3066 7771, email [email protected]
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Abstract

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Considering the negative effects of secondary hyperparathyroidism (SHPT) in patients with chronic renal failure (CRF), the objective of the present study was to evaluate body composition changes using conventional and vector bioimpedance analysis in patients before and after parathyroidectomy (PTX). Twelve adult patients, mean age 43·4 (sd 12·7) years, were evaluated prior to and 6 months after PTX. Diets were assessed with 3d dietary records, and mean energy, protein, calcium and phosphorus intake were estimated from these inventories. Weight, height, BMI and bioelectrical impedance were measured; and biochemical markers of nutritional status (albumin and total protein) and bone metabolism (calcium, phosphorus and intact parathyroid hormone) were determined. No significant differences were observed in mean energy, protein and phosphorus after surgery. There was a significant increase in calcium intake after PTX (382·3 (sd 209·6) mg to 656·6 (sd 313·8) mg; P<0·05). Mean weight, BMI, conventional bioelectrical impedance measurements, total body fat, lean body mass and total body water were unaffected by surgery. However, the phase angle and reactance significantly increased after PTX (5·0° (sd 1·4) to 5·6° (sd 1·3); 44·1 (sd 15·6) Ω to 57·1 (sd 14·4) Ω, respectively). The high levels of intact parathyroid hormone before surgery had a negative effect on total body fat (r −0·69, P<0·05). After PTX, the mean albumin significantly increased (3·9 (sd 0·4) g/dl to 4·2 (sd 0·6) g/dl; P<0·05). PTX for SHPT is associated with certain changes in laboratory values, dietary intake and body composition. The latter is best seen with bioimpedance vector analysis.

Keywords

Body compositionSecondary hyperparathyroidismBioimpedance vector analysis
Type
Research Article
Information
British Journal of Nutrition , Volume 95 , Issue 2 , February 2006 , pp. 353 - 357
Copyright
Copyright © The Nutrition Society 2006

References

Amann, K, Gross, ML, London, GM & Ritz, EHyperphosphataemia–a silent killer of patients with renal failure?” Nephrol Dial Transplant 1999 14 2085–2087CrossRefGoogle ScholarPubMed
Bacynski, R, Massry, SG, Magott, M, El-Belbessi, S, Kohan, R & Brautbar, NEffect of parathyroid hormone on energy metabolism of skeletal muscle. Kidney Int 1985 28 722–727CrossRefGoogle Scholar
Bergström, J & Lindholm, BNutrition and adequacy of dialysis:how do hemodialysis and CAPD compare?”. Kidney Int 1993 43 39S–50SGoogle Scholar
Bossola, M, Muscaritoli, M, Tazza, L, Panocchia, N, Liberatori, M, Giungi, S, Tortorelli, A, Fanelli, FR & Luciani, GVariables associated with reduced dietary intake in hemodialysis patients. J Ren Nutr 2005 15 244–252CrossRefGoogle ScholarPubMed
Chertow, G, Jacobs, D, Lazarus, J, Lew, N & Lowrie, EPhase angle predicts survival in hemodialysis patients. J Renal Nutr 1997a 7 204–207CrossRefGoogle Scholar
Chertow, GM, Lazarus, JM, Lew, NL, Ma, L & Lowrie, EGBioimpedance norms for the hemodialysis population. Kidney Int 1997b 52 1617–1621CrossRefGoogle ScholarPubMed
Chertow, GM, Lowrie, EG, Wilmore, DWet al. Nutritional assessment with bioelectrical impedance analysis in maintenance hemodialysis patients. J Am Soc Nephrol 1995 6 75–81CrossRefGoogle ScholarPubMed
Cooper, BA, Aslani, A, Ryan, M, Zhu, FY, Ibels, LS, Allen, BJ & Pollock, CAComparing different methods of assessing body composition in end-stage renal failure. Kidney Int 2000 58 408–416CrossRefGoogle ScholarPubMed
Cozzolino, M, Brancaccio, D, Gallieni, M, Galassi, A, Slatopolsky, E & Dusso, APathogenesis of parathyroid hyperplasia in renal failure. J Nephrol 2005 18 5–8Google ScholarPubMed
Dumler, FHypoalbuminemia is a marker of overhydration in chronic maintenance patients on dialysis. ASAIO J 2003 49 282–286CrossRefGoogle ScholarPubMed
Dumler, F & Kilates, CUse of bioelectrical impedance techniques for monitoring nutritional status in patients on maintenance dialysis. J Renal Nutr 2000 10 116–124CrossRefGoogle ScholarPubMed
Foster, KR & Lukasky, HCWhole-body impedance. What does it measure?” Am J Clin Nutr 1996 64 388–396CrossRefGoogle ScholarPubMed
Francisco, ALSecondary hyperparathyroidism: review of the disease and its treatment. Clin Ther 2004 26 1976–1993CrossRefGoogle ScholarPubMed
Ikizler, TA, Wingard, RL, Harvell, J, Shyr, Y & Hakim, RMAssociation of morbidity with markers of nutrition and inflammation in chronic hemodialysis patients: a prospective study. Kidney Int 1999 55 1945–1951CrossRefGoogle ScholarPubMed
Jofré, R, Goméz, JML, Menárguez, J, Pólo, JR, Guinsburg, M, Villaverde, T, Flores, IP, Carretero, D, Benitez, PR &García, RPParathyroidectomy: whom and when?”. Kidney Int 2003 63 S97–S100CrossRefGoogle Scholar
Johansen, KL, Kaysen, GA, Young, BS, Hung, AM, da Silva, M & Chertow, GMLongitudinal study of nutritional status, body composition, and physical function in hemodialysis patients. Am J Clin Nutr 2003 77 842–846CrossRefGoogle ScholarPubMed
Kaysen, GAThe microinflammatory state in uremia: causes and potential consequences. J Am Soc Nephrol 2001 12 1549–1557CrossRefGoogle Scholar
Kaysen, GAInflammation: cause of vascular disease and malnutrition in dialysis patients. Semin Nephrol 2004 24 431–436CrossRefGoogle ScholarPubMed
Kaysen, GA, Chertow, GM, Adhikarla, R, Young, B, Ronco, C & Levin, NWInflammation and dietary protein intake exert competing effects on serum albumin and creatinine in hemodialysis patients Kidney Int 2001 60 333–340CrossRefGoogle ScholarPubMed
Khajehdehi, P, Ali, M, Al-Gebory, F, Henry, G & Bastani, BThe effects of parathyroidectomy on nutritional and biochemical status of hemodialysis patients with severe secondary hyperparathyroidism. J Renal Nutr 1999 9 186–191CrossRefGoogle ScholarPubMed
Kushner, RF, Roxe, DMBipedal bioelectrical impedance analysis reproducibly estimates total body water in hemodialysis patients. Am J Kidney Dis 2002 39 154–158CrossRefGoogle ScholarPubMed
Lukaski, HC, Johnson, PE, Bolonchuk, WW & Lykken, GIAssessment of fat-free mass using bioelectrical impedance measurements of the human body Am J Clin Nutr 1985 41 810–817CrossRefGoogle ScholarPubMed
Miroslaw, S, Grazina, P, Peggy, R, Borum, G, Shaul, G & Massry, SGChronic renal failure, parathyroid hormone and fatty acids oxidation in skeletal muscle. Kidney Int 1988 33 555–560Google Scholar
Mushnick, R, Fein, PA, Mittman, N, Goel, N, Chattopadhyay, J & Avram, MMRelationship of bioelectrical impedance parameters to nutrition and survival in peritoneal dialysis patients. Kidney Int 2003 83 S53–S56CrossRefGoogle Scholar
National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003 42 S1–S202CrossRefGoogle Scholar
Oldham, NMOverview of bioelectrical impedance analysers. Am J Clin Nutr 1996 64 405–412CrossRefGoogle Scholar
Peters, BSE, Jorgetti, V & Martini, LA (in press) Influência do hiperparatireoidismo secund´rio grave no estado nutricional de pacientes com insuficiôncia renal crônica. Rev NutrGoogle Scholar
Piccoli, AIdentification of operational clues to dry weight prescription in hemodialysis using bioimpedance vector analysis. Kidney Int 1998 53 1036–1043CrossRefGoogle ScholarPubMed
Piccoli, A & Pastori, GBIVA Software. Padova: Department of Medical and Surgical Sciences, University of Padova(available by e-mail from [email protected]) 2002aGoogle Scholar
Piccoli, A, Rossi, B, Pillon, L & Bucciante, GA new method for monitoring body fluid variation by bioimpedance analysis: the RXc graph. Kidney Int 1994 46 534–539CrossRefGoogle ScholarPubMed
Qureshi, AR, Alvestrand, A, Divino-Filho, JC, Gutierrez, A, Heimburger, O, Lindholm, B & Bergstrom, JInflammation, malnutrition, and cardiac disease as predictors of mortality in hemodialysis patients J Am Soc Nephrol 2002 13 28S–36SCrossRefGoogle ScholarPubMed
Salem, MMHyperparathyroidism in the hemodialysis population:a survey of 612 patients. Am J Kidney Dis 1997 29 862–865CrossRefGoogle ScholarPubMed