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 ...
Nutrição e Doenças da Paratireoide – Artigo 3
Severe hyperparathyroidism is associated with nutritional impairment in maintenance
hemodialysis patients
ABSTRACT
Severe hyperparathyroidism predicts poor outcomes in patients with kidney failure. Mechanisms underlying the relationship between high parathyroid hormone (PTH) and decreased survival other than bone loss are largely unexplored. Recent evidence suggests the role of excess PTH in adipose tissue browning resulting in protein-energy wasting. The present retrospective observational study examined nutritional status among patients receiving maintenance hemodialysis with different ...
Nutrição e Doenças da Paratireiode – Artigo 2
Hyperparathyroidism, Serum Phosphorus and Dietary Intake in Hemodialysis Patients: Is There a Novel Relationship?
Abstract: The management of hyperparathyroidism (intact parathyroid hormone (iPTH) serum levels > 585 pg/mL), frequently focuses on the appropriate control of mineral and bone markers, with the decrease in serum and dietary phosphorus as two of the targets. We aimed to investigate the association between iPTH, serum phosphorus levels and dietary intake. This was a cross-sectional, multicenter, observational study with 561 patients on hemodialysis treatment. Clinical parame...
