Relationship between parathyroid hormone levels and sarcopenia and nutritional status in patients undergoing hemodialysis.

INTRODUCTION

The potential effect of elevated parathyroid hormone (PTH) levels on nutritional status and sarcopenia in chronic kidney disease (CKD) patients undergoing hemodialysis (HD) has not yet been well established.

OBJECTIVE

The aim of this study was to evaluate the status of sarcopenia and nutritional aspects according to PTH levels in HD patients.

METHODS

This cross-sectional study evaluated consecutive patients attending three HD clinics in Northeast Brazil. Patients were stratified based on PTH levels: (1) 0-199 pg/mL, (2) 200-599 pg/mL, and (3) ≥ 600 pg/mL. Group 1 was excluded due to older age, and groups 2 and 3 were matched for age, sex, and presence of diabetes. Sarcopenia was defined according to the European consensus criteria, assessing muscle strength, muscle mass, muscle quality index, and body mass index.

RESULTS

A total of 238 individuals were evaluated (119 in each group), with a mean age of 49.3 ± 14.4 years. The prevalence of sarcopenia was 18.5%, and 66.7% exhibited low muscle quality. Underweight was observed in 6.3% of the sample, while 41.4% were overweight. There were no differences in rates of underweight, low muscle mass, low muscle strength, sarcopenia, and low muscle quality according to PTH status (p > 0.05).

CONCLUSION

Patients undergoing HD with moderate to severe hyperparathyroidism (PTH ≥ 600 pg/mL) did not show higher nutritional impairment or sarcopenia compared to patients with PTH levels within the recommended range (200-599 pg/mL).