Increased resting energy expenditure in hemodialysis patients with severe hyperparathyroidism.
نویسندگان
چکیده
Several metabolic derangements, including enhanced protein catabolism, have been suggested to be associated with increased circulating parathyroid hormone (PTH) in patients with secondary hyperparathyroidism (HPT). Such conditions, therefore, might lead to an increase in energy expenditure. The present study examined by indirect calorimetry the resting energy expenditure (REE) of 15 hemodialysis patients who have severe HPT (PTH = 1457 +/- 676 pg/ml) and were pair-matched for age and gender to 15 hemodialysis patients with mild to moderate HPT (PTH = 247 +/- 196 pg/ml). Both groups were also pair-matched for age and gender to a group of 15 healthy adult subjects (control). In six patients from the severe HPT group submitted to total parathyroidectomy, REE was determined 6 mo after the surgery. The groups were not different regarding lean body mass (LBM) measured by bioelectric impedance, serum C-reactive protein, and bicarbonate. Thyroid-stimulating hormone was within the normal range in all groups. Nonadjusted REE was significantly higher in the severe HPT group (1674 +/- 337 kcal/d) compared with patients with mild to moderate HPT (1388 +/- 229 kcal/d; P < 0.05). Both groups did not differ from the control group (1468 +/- 323 kcal/d). When adjustment of REE for LBM was performed using the multiple regression analysis, patients with mild to moderate HPT and control subjects had significantly lower REE (-231 and -262 kcal, respectively) than that of the severe HPT group. Considering all patients together, nonadjusted REE correlated directly with LBM (r = 0.61; P < 0.01). PTH correlated strongly with LBM in the severe HPT group (r = -0.82; P < 0.01). In the multiple linear regression analysis, only LBM and PTH were independent determinants of REE (n = 30; R(2) = 0.47). REE decreased significantly in the six patients who were evaluated 6 mo after parathyroidectomy (from 1617 +/- 339 to 1226 +/- 253; P = 0.02). These results demonstrate that hemodialysis patients with severe HPT have increased REE that might be reduced after parathyroidectomy.
منابع مشابه
Catabolism in chronic heart failure.
Why can chronic heart failure be a catabolic state? The resting metabolic rate of some, but not all patients with heart failure is increased. Resting metabolic rate may account for up to 70% of daily energy expenditure in heart failure, and increases with NYHA functional class. Resting energy expenditure accounts for a greater proportion of daily energy expenditure in heart failure patients, al...
متن کاملIntensification of Anemia by Secondary Hyperparathyroidism in Hemodialysis Patients
The excessive amounts of parathyroid hormone in secondary hyperparathyroidism (SHPTH) is suggested to interfere with normal erythropoiesis. In SHPTH, during chronic renal failure, due to the impairment of erythropoietin synthesis, this effect is more pronounced. In the present study the role of secondary hyperparathyroidism in the severity of anemia was evaluated in hemodialysis patients (n=3...
متن کاملمقایسهی میزان متابولیسم استراحت، ترکیب بدن و پروفایل لیپیدی در زنان مبتلا به کمکاری آشکار تیروئید تحت درمان با لووتیروکسین با و بدون علائم بالینی
Background: The major cause of obesity is an imbalance between energy intake and energy expenditure and resting energy expenditure (REE) is the most important determining factor in metabolism because it can reduce obesity and body fat mass gain. Overt hypothyroidism is associated with a lower resting energy expenditure (REE). With treatment, the resting energy expenditure (REE) will be normal. ...
متن کاملLiterature review in the treatment of calciphylaxis:A case with uncontrolled and severe secondary hyperparathyroidism
Background: Calciphylaxis is a serious disorder often observed in dialysis patients and less frequently in chronic renal failure patients with secondary hyperparathyroidism. Mortality rate increases following the development of calciphylaxis, immediate application of parathyroidectomy along with other treatment options may be lifesaving. Case Presentation: A 44-year-old male patient had been...
متن کاملAre prediction equations reliable for estimating resting energy expenditure in chronic kidney disease patients?
BACKGROUND The determination of resting energy expenditure (REE) is the primary step for estimating the energy requirement of an individual. Although numerous equations have been formulated for predicting metabolic rates, there is a lack of studies addressing the reliability of those equations in chronic kidney disease (CKD). Thus, the aim of this study was to evaluate whether the main equation...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of the American Society of Nephrology : JASN
دوره 15 11 شماره
صفحات -
تاریخ انتشار 2004