Association of secondary hyperparathyroidism with malnutrition and inflammation in maintenance hemodialysis patients

摘要

This study conducted to found out the association of high PTH levels with various indices of malnutrition and inflammation in hemodialysis (HD) patients. Intact serurm PTH (iPTH) and serum C-reactive protein (CRP), serum calcium (Ca), phosphorus (P), Alkaline Phosphatase (ALP), serum cholesterol (chol) and serum triglyceride (TG) were measured. Total patients were 36 (f=15 m=21). The mean patient's age was 44(±17) years. The value of serum iPTH of all HD patients was 434+455 pg/mL, the value of serum iPTH of diabetic and non-diabctic dialysis patients were 201±277 and 537±483 pg/mL, respectively. In this study we found a significant positive correlation of serum iPTH with serum CRP, a significant inverse correlation of serum iPTH with BMI and a significant positive correlation of serum ALP with Logarithm of CRP. Also a significant positive correlation of serum phosphorus with serum CRP and a significant inverse correlation of serum phosphorus with BMI were found. When patients with iPTH below than 200 pg/mL were deleted, the correlation of iPTH with CRP became positive (r=0.42, p =0.085) and when patients with iPTH more than 500pg/mL were deleted, this correlation was found to be negative (r=-0.42, p:0.047), which means that a low iPTH value is an index of malnutrition while higher value is associated with inflammation. Further attention needs to better control of hyperphosphatemia and maintaining the iPTH levels l.5 times of normal to avoid the sides effects of secondary hyperparathyroidism.