Nutrição e Doenças da Paratireoide – Intervenção Nutricional
Associados, juntamente com os artigos do mês, vocês receberão uma cartilha resumo com as principais intervenções nutricionais da condição/ doença que é tema do mês! A cartilha resumo poderá ser utilizada como um material de apoio para o momento do atendimento nutricional, facilitando a prescrição de condutas com base nos dados mais recentes dos estudos científicos.
Nutrição e Doenças da Paratireoide – Artigo 10
Hiperparatireoidismo secundário devido à doença renal crônica e acesso ao tratamento clínico e à paratireoidectomia no Brasil: uma pesquisa nacional
Resumo
Introdução: A doença renal crônica (DRC) pode levar ao hiperparatireoidismo secundário (HPTS) e seu tratamento baseia-se no controle da hiperfosfatemia, hipocalcemia e níveis séricos de paratormônio (PTH). Apesar dos avanços no tratamento do HPTS, a falha terapêutica é frequente, e pacientes com DRC em diálise demandam paratireoidectomia (PTx).
Objetivo: Atualizar a pesquisa de 2011, estimar a prevalência atual de ...
Nutrição e Doenças da Paratireoide – Artigo 9
Normocalcemic primary hyperparathyroidism
Summary
Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed ...
Nutrição e Doenças da Paratireoide – Artigo 8
Tratamento do Hiperparatiroidismo secundário (HPTS)
Pacientes com DRC E3-5
1. Os níveis ideais de PTH não estão estabelecidos para pacientes com DRC E3-5 (Evidência).
1.1 Se os níveis séricos de PTH estiverem em elevação progressiva ou persistentemente acima do valor de referência para o método, deve-se avaliar os níveis séricos de cálcio (Ca), fósforo (P), fração de excreção urinária de P (se disponível), fosfatase alcalina (FA) e 25-hidroxivitamina D (25-vit D) (Evidência).
1.2 As alterações encontradas devem ser corrigidas: sais de Ca para hipocalcemia, ...
Nutrição e Doenças da Paratireoide – Artigo 7
Insights into Nutritional and Inflammatory Aspects of Low Parathyroid Hormone in Dialysis Patients
Abstract
In people with advanced chronic kidney disease (CKD), secondary hyperparathyroidism is associated with high-turnover bone disease. A low serum PTH may not necessarily be due to hypodynamic bone but another facet of the malnutrition-inflammation cachexia-syndrome (MICS). A recent 5-year cohort study in 748 stable hemodialysis outpatients showed that after removing the confounding by the MICS, the moderately low PTH in 100 to 150 p/ml range was associated with the greatest survival. ...
Nutrição e Doenças da Paratireoide – Artigo 6
Hypoparathyroidism: update of guidelines from the 2022 International Task Force
ABSTRACT
The 2022 International Task Force guidelines for chronic hypoparathyroidism will be published within several months in the Journal of Bone and Mineral Research. These guidelines update the original guidelines published in 2016, and include new information from literature published since then. Chronic postsurgical hypoparathyroidism is now defined as lasting for at least 12 months after surgery, rather than 6 months. Chronic postsurgical hypoparathyroidism may be predicted by serum PTH <10 pg/mL in ...
Nutrição e Doenças da Paratireoide – Artigo 5
Management of Hypoparathyroidism
ABSTRACT
Hypoparathyroidism (HypoPT) is a rare disorder characterized by hypocalcemia in the presence of a low or inappropriately normal parathyroid hormone level. HypoPT is most commonly seen after neck surgery, which accounts for approximately 75% of cases, whereas approximately 25% have HypoPT due to nonsurgical causes. In both groups of patients, conventional therapy includes calcium and active vitamin D analogue therapy aiming to maintain serum calcium concentration in the low normal or just below the normal reference range and normalize serum ...
Nutrição e Doenças da Paratireoide – Artigo 4
The Role of Diet in Bone and Mineral Metabolism and Secondary Hyperparathyroidism
Abstract: Bone disorders are a common complication of chronic kidney disease (CKD), obesity and gut malabsorption. Secondary hyperparathyroidism (SHPT) is defined as an appropriate increase in parathyroid hormone (PTH) secretion, driven by either reduced serum calcium or increased phosphate concentrations, due to an underlying condition. The available evidence on the effects of dietary advice on secondary hyperparathyroidism confirms the benefit of a diet characterized by decreased phosphate intake, avoiding ...
