Chonnam Med J.  2002 Dec;38(4):332-337.

Relation between the Protein Intake, and Serum Phosphorus and Parathyroid Hormone Levels in Hemodialysis Patients

• Lee KS
• Lee YK
• Park BS
• Jeong TK
• Jeong GH
• Ma SK
• Kim SW
• Kim NH
• Choi KC

Abstract

In maintenance hemodialysis (MHD) patients, advanced age is a factor associated with relative hypo- parathyroidism and an adynamic bone disease. However, the underlying mechanism remains elusive. The aim of the present study was to analyze whether the observed spontaneous decrease in protein intake in MHD patients decreases serum phosphorus (P) and parathyroid hormone (PTH) levels. A cross-sectional study including 107 MHD patients dialyzed 4 hours 3 times a week from Chonnam National University Hospital was performed. Serum calcium, phosphorus, and intact PTH (iPTH) levels were determined. nPCR and Kt/V were also determined to evaluate nutritional status and dialysis adequacy. One-way analysis of variance showed that serum ionized calcium levels increased with age (p=0.030). In addition, patients with serum phosphorus levels lower than 4 mg/dL as compared with those with 4 mg/dL or higher had a lower nPCR (p=0.006) and iPTH levels. Additionally, a significant positive correlation was between serum phosphorus levels and nPCR (p=0.001). A stepwise multiple regression analysis to predict iPTH levels showed that serum ionized calcium was the best predictor (p=0.018). The results obtained in the present study suggest that a lower serum phosphorus levels due to spontaneous reduction of protein intake might contribute to the relative low PTH levels observed in MHD patients. Also, serum ionized calcium was the predictor of serum PTH levels.

Keyword

Protein intake; Phosphorus; Parathyroid hormone; Adynamic bone disease; Hemodialysis

MeSH Terms

Bone Diseases
Calcium
Cross-Sectional Studies
Dialysis
Humans
Jeollanam-do
Nutritional Status
Parathyroid Hormone*
Phosphorus*
Renal Dialysis*
Calcium
Parathyroid Hormone
Phosphorus