Prevalencia del síndrome complejo de malnutrición e inflamación y su correlación con las hormonas tiroideas en pacientes en hemodiálisis crónica

Valencia, Venice Chávez; Mejía-Rodríguez, Oliva; Sandoval, Martha Eva Viveros; Bermúdez, Juan Abraham; Castellanos, Sergio Gutiérrez; Cruz, Citlalli Orizaga de la; Cordova, Martha

doi:10.1016/j.nefro.2017.07.001

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…As a consequence to the convergent input of inflammation in the pathophysiology of PEW and CV disease, the term malnutrition-inflammation-atherosclerosis syndrome was established in patients with ESKD [64]. Remarkably, a prevalence of MIA of 53.9% is reported in patients on HD [65]. Consistent with CV impairments being the cornerstone of MIA, the finding that PEW (by MNA and CRP) associates with impairments in cardiorespiratory function, assessed via the 6MWT, is not unexpected.…”

Section: Plos Onementioning

confidence: 92%

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

et al. 2020

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Background Physical impairments are common in uraemia, as reflected by the high risk of falls of haemodialysis (HD) patients. Furthermore, these patients often suffer from malnutrition. Objective Up to now, it is unknown which aspects of physical performance are predominantly driven by malnutrition in HD patients. As this answer could steer different interventions, the aim of this study was to evaluate the cross-sectional relationship between nutritional status, muscle strength, exercise capacity and the risk of falls. Methods This study recruited HD patients between December 2016 and March 2018 from two hospital-based and five satellite dialysis units (registration number on clinicaltrial.gov: NCT03910426). The mini-nutritional assessment scale as well as objective measures of protein-energy wasting were obtained (total iron-binding capacity, total protein levels, and CRP). Physical assessment included muscle strength (quadriceps, handgrip force, and sitto-stand test), exercise capacity (six-minute walking test) and the risk of falls (Tinetti, FIC-SIT, and dialysis fall index). Their interrelationship was analysed by ridge regression models. Results Out of 113 HD patients (mean age 67 years ± 16.1, 57.5% male) 36.3% were malnourished according to the mini-nutritional assessment scale and a majority had impaired quadriceps force (86.7%), six-minute walking test (92%), and an increased risk of falls (73.5%). Total protein and CRP levels were identified as relevant nutritional factors in the association with physical performance. Nutritional parameters explained 9.2% of the variance in the risk of

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Section: Plos Onementioning

confidence: 92%

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

et al. 2020

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“…These findings of higher FT3 and T4 in farmers are in line with the work of Kongtip (2019), which reported an increase in TSH, FT3, T3, and T4 levels in conventional farmers relative to organic farmers in Thailand [ 6 , 7 ]. The higher frequency of hypothyroid for FT3 in non-farmers should be further explored, because a study by Chavez (2013) showed that 11.7% of respondents with complex inflammatory malnutrition syndrome had a low FT3 level, and this was also associated with IL-6, C-reactive protein, and albumin [ 29 ]. Low FT3 is included in non-thyroid disease (NTI), which is a counter-regulatory response that causes a waste of energy and protein in acute and chronic stress conditions, such as uncontrolled diabetes mellitus with ketoacidosis, myocardial infarction, and severe myocardial ischemia, and in almost all severe diseases [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Thyroid Hormone Levels between Women Farmers and Non-Farmers in Banten Indonesia

Mardhiyah

Komaruddin

Jalal

et al. 2021

IJERPH

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Pesticides are suspected of being endocrine disruptors. This cross-sectional study measured serum samples for levels of thyroid hormones including thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4) among Indonesian female farmers (n = 127) and non-farmers (n = 127). A questionnaire was used to collect information on demographics and risk factors including work characteristics and frequency, and the use of home and agricultural pesticides. Results showed that there were no significant differences in the distribution of the clinical categories of thyroid levels between farmers and non-farmers except for FT3 and T4. However, in multivariable regression controlling for confounders, FT3 and T4 were significantly higher for farmers compared to non-farmers. In addition, 32% of farmers had clinically low iodine levels and 49% of non-farmers had clinically high iodine levels. We conclude that pesticide exposure may not be as important as iodine intake in explaining these findings. We recommend counseling by health workers about the importance of using iodized salt for farmers and counseling about high iodine foods that need to be avoided for non-farmers.

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“…Previous studies have widely investigated the prognostic value of the presence of non-thyroidal illness for long-term mortality in chronic HD patients and its potential association with low-grade inflammation, a common feature of uraemia [ 34 ]. In haemodialysed patients, serum T3 and fT3 levels have been inversely correlated with malnutrition and inflammation parameters (hsCRP, interleukin-6), because malnutrition–inflammation complex syndrome can affect serum concentrations of thyroid hormones [ 9 , 10 , 31 , 35 ]. On the contrary, previous studies reported an association between a state of malnutrition–inflammation–atherosclerosis syndrome and poor dialysis outcome in ESRD patients [ 9 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

OUP accepted manuscript

Netti

Rotondi

Lorenzo

et al. 2020

Clinical Kidney Journal

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Background End-stage renal disease (ESRD) is associated with a broad spectrum of morphological and functional thyroid disorders. Recent studies have shown that low free triiodothyronine (fT3) levels are related to inflammatory status and endothelial activation in ESRD patients on haemodialysis (HD). Limited data exist about a possible relationship between dialysis regimen, namely long nocturnal haemodialysis (LNHD), and thyroid function parameters. The aim of this study was to evaluate the relationship between dialysis regimen and thyroid function, and consequently with the main patient outcomes. Methods To this purpose, we performed a retrospective, single-centre cohort study including 220 incident chronic HD patients treated during an 8-year period (from January 2010 to December 2017). The main clinical and haematochemical parameters, including thyroid function, were evaluated and related to the main patient outcomes. Results Patients with low fT3 levels (<3.05 ng/mL) showed significantly lower survival rates than patients with normal fT3 levels (>3.05 ng/mL) (P < 0.001), although there were no substantial differences in the demographic and clinical characteristics between the two groups. After propensity score 1:3 matching of 25 patients treated with nocturnal HD to 75 patients treated with diurnal HD, LNHD patients showed significantly higher survival rates (88.0% versus 61.3%, P = 0.001) and lower incidence of cardiovascular events than patients on diurnal dialysis (8.0% versus 40.0%, P = 0.001). Moreover, an 8-year time-dependent analysis showed that at any time, except for baseline, the rate of patients with fT3 levels >3.05 ng/mL was significantly higher in LNHD patients than in patients treated with diurnal dialysis. Conclusions Our data suggest that the application of alternative dialysis regimens, also reducing the frequency of low T3, could ameliorate outcomes and therefore reduce the incidence of cardiovascular events in HD patients.

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Prevalencia del síndrome complejo de malnutrición e inflamación y su correlación con las hormonas tiroideas en pacientes en hemodiálisis crónica

Abstract: Low T3 and FT3 levels are correlated with malnutrition and inflammation parameters. Malnutrition-inflammation complex syndrome can affect serum concentrations of thyroid hormones.

Cited by 10 publications

References 27 publications

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

Comparison of Thyroid Hormone Levels between Women Farmers and Non-Farmers in Banten Indonesia

OUP accepted manuscript

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