%0 Journal Article
%T The association of markers of oxidative-inflammatory status with malnutrition in hemodialysis patients with serum ferritin lower than 500 ng/mL Associa  o dos marcadores do estado oxidativo e inflamat¨®rio com a desnutri  o em pacientes hemodialisados com ferritina menor do que 500 ng/mL
%A Simone Gon£¿alves de Almeida
%A Joel Paulo Russomano Veiga
%A Sandra Fernandes Arruda
%A Cibele Ferreira Neves
%J Jornal Brasileiro de Nefrologia
%D 2013
%I Sociedade Brasileira de Nefrologia
%X INTRODUCTION: Enhanced inflammatory-oxidative status is well established in chronic kidney disease. OBJECTIVE: The objective of this study was to evaluate the oxidative- inflammatory status and iron indices in patients undergoing maintenance hemodialysis (HD) with serum ferritin lower than 500ng/mL, and to correlate them with nutritional status. METHOD: In a cross-sectional survey 35 HD patients (23 with normal nutritional status, 12 with Protein-Energy-Wasting syndrome, PEW), and healthy volunteers (n = 35) were studied. Serum concentration of iron, ferritin, transferrin saturation, malondialdehyde (MDA), protein carbonyl (PC), high-sensitive serum C -reactive protein (hs-CRP) and blood counts were determined. The nutritional status was determined by anthropometric and biochemical criteria. RESULTS: HD patients showed low values of hemoglobin and higher values of ferritin, MDA and PC when compared with healthy volunteers. HD subjects with PEW had higher values of PC and hs-PCR as compared to HD patients with normal nutritional status. A multiple logistic regression analysis showed that the independent variables PC (Wald Statistic 4.25, p = 0.039) and hs-CRP (Wald Statistic 4.83, p = 0.028) where related with the patients' nutritional condition. CONCLUSION: In HD patients with serum ferritin below 500 ng/mL was observed one association of the markers of oxidative stress and inflammation with poor nutritional status independently of serum ferritin, gender and age. INTRODU  O: Na doen a renal cr nica, a presen a de um estado inflamat¨®rio-oxidativo aumentado est¨¢ bem estabelecida. OBJETIVO: O objetivo do presente estudo foi avaliar o estado oxidativo e inflamat¨®rio e o perfil do ferro em pacientes submetidos ¨¤ hemodi¨¢lise cr nica de manuten  o, com ferritina menor do que 500 ng/mL, e correlacion¨¢-los com o estado nutricional. M¨¦TODO: Em estudo transversal, em 35 pacientes sob hemodi¨¢lise (23 com estado nutricional normal, 12 com desnutri  o energ¨¦tico-proteica (DEP) e 35 volunt¨¢rios sadios foram determinados os ¨ªndices hematim¨¦tricos e as concentra  es s¨¦ricas do ferro, da ferritina e avaliada a satura  o de transferrina. O estado oxidativo foi determinado por meio das concentra  es s¨¦ricas do malondialde¨ªdo (MDA) e da prote¨ªna carbonil (PC). Nos indiv¨ªduos sob hemodi¨¢lise o estado inflamat¨®rio foi avaliado por meio da prote¨ªna C reativa ultrassens¨ªvel determinada no soro (hs-PCR). O estado nutricional foi determinado por crit¨¦rios antropom¨¦tricos e bioqu¨ªmicos. RESULTADOS: Os pacientes da hemodi¨¢lise mostraram anemia e um estado oxidativo mais elevado do
%K ferro na dieta
%K di¨¢lise renal
%K estado nutricional
%K estresse oxidativo
%K inflama  o
%K inflammation
%K iron
%K dietary
%K nutritional status
%K oxidative stress
%K renal dialysis
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002013000100002