Chruściel B, Stompór T, Sułowicz W
Katedra i Klinika Nefrologii CM UJ ul. Kopernika 15c, 31-501 Kraków.
Przegl Lek. 2001;58(9):828-32.
Malnutrition is very frequent comorbid factor in chronic renal failure and its prevalence both in the predialysis period as well as on maintenance dialysis is high. The aim of the study was to assess the nutritional status in patients after successful kidney transplantation. 109 patients (47 F, 67 M) of mean age 39.9 +/- 11.5 years were analyzed. Mean time after transplantation surgery was 32.2 +/- 37 months and the maintenance dialysis treatment period prior to transplantation--28.4 +/- 22 months. Nutritional status was assessed with clinical examination based on the SGA scale, anthropometric measurements as well as body composition estimation with bioimpedance. Daily food intake was also monitored with three-day dietary questionnaire. All above analyses were also performed in 25 healthy control subjects with corresponding sex and age distribution. No differences between all analyzed bioimpedance and anthropometry parameters were found between studied patients and controls. 79% of patients were classified as well nourished, 20%--as mildly or moderately malnourished and only 1%--as severely malnourished according to SGA scale. The BMI values less than 21 kg/m2, i.e. suggesting malnutrition were found in 23.3% of patients, whereas values above 25 kg/m2, i.e. suggesting overweight or obesity--in almost 40%. Interestingly, as high as 82.5% of studied patients were characterized by significant weight gain since last "dry weight" assessment on maintenance dialysis up to the time of study (by mean 9.42 +/- 6.9 kg). Obtained results permit us to conclude, that the prevalence of nutritional status abnormalities are relatively frequent among patients with functioning graft. Malnutrition can be demonstrated in more than 20% of the study population, which should be considered however to be markedly lower as compared to most reports regarding dialysis populations. Weight gain during posttransplant period as compared to maintenance dialysis is marked and common; thus the prevalence of obesity is also quite common and reaches 40% of tested patients.
营养不良是慢性肾衰竭中非常常见的合并症因素,其在透析前阶段以及维持性透析阶段的患病率都很高。本研究的目的是评估肾移植成功后患者的营养状况。分析了109例患者(47例女性,67例男性),平均年龄39.9±11.5岁。移植手术后的平均时间为32.2±37个月,移植前的维持性透析治疗时间为28.4±22个月。通过基于主观全面评定(SGA)量表的临床检查、人体测量以及生物电阻抗法进行身体成分估计来评估营养状况。还通过为期三天的饮食问卷监测每日食物摄入量。对25名具有相应性别和年龄分布的健康对照者也进行了上述所有分析。在研究患者和对照者之间,未发现所有分析的生物电阻抗和人体测量参数存在差异。根据SGA量表,79%的患者被归类为营养良好,20%为轻度或中度营养不良,只有1%为重度营养不良。23.3%的患者体重指数(BMI)值低于21kg/m²,即提示营养不良,而高于25kg/m²,即提示超重或肥胖的患者比例近40%。有趣的是,高达82.5%的研究患者自维持性透析的上次“干体重”评估至研究时体重显著增加(平均增加9.42±6.9kg)。获得的结果使我们得出结论,在移植肾功能良好的患者中,营养状况异常的患病率相对较高。超过20%的研究人群存在营养不良,但与大多数关于透析人群的报告相比,这一比例应被视为明显较低。与维持性透析相比,移植后体重增加明显且常见;因此肥胖的患病率也相当高,达到了40%的受试患者。