Grzegorzewska Alicja E, Leander Magdalena, Młot-Michalska Monika
Katedra i Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych AM im. K. Marcinkowskiego w Poznaniu.
Pol Arch Med Wewn. 2006 Aug;116(2):736-40.
The aim of our study was to evaluate relations between peritoneal dialysis (PD) adequacy and nutritional parameters of PD patients. Patients (n = 124), who finished PD treatment, were separated on 2 groups according to the mean total Kt/V for the entire PD course being below 2.0 (group I) or over 2.0 (group II). Adequacy parameters, daily intake of food products and nutritional indices were evaluated in each patient every 3-6 months during the entire PD course. Mean values of examined parameters were used for comparison of differences observed between both groups. Group I included 63 men, 16 women, age 50.3 +/- 13.8 years, PD duration 13.2 +/- 10.1 months. Group II consisted of 12 men, 33 women, age 49.1 +/- 14.9 years, PD duration 8.8 +/- 6.0 months. Due to a significant difference in sex distribution, dialysis duration and ideal body mass (IBM) between groups, statistical analysis was performed with adjustment of results to these parameters. Absolute amounts of daily intake of food components were higher in group I for animal protein, sodium, retinol, niacin, saturated and polyunsaturated fatty acids and cholesterol. When daily food intake was normalized to IBM, group II showed higher both protein nitrogen appearance (I - 0.92 +/- 0.25, II - 1.12 +/- 0.45 g/kg IBM, p = 0.005) and intake of vegetable protein (I - 0.29 +/- 0.10, II - 0.34 +/- 0.09 g/kg IBM, p = 0.040), carbohydrates (I - 3.30 +/- 1.08, II - 3.80 +/- 1.34 g/kg IBM, p = 0.029), potassium (I - 33.2+/-10.6, II - 38.3 +/- 13.2 mg/kg IBM, p = 0.034), calcium (I - 5.81 +/- 2.46, II - 7.20 +/- 3.54 mg/kg IBM, p = 0.028), magnesium (I - 2.86 +/- 0.86, II - 3.41 +/- 1.36 mg/kg IBM, p = 0.004), beta-carotene (I 22.4 +/- 15.8, II - 34.9 +/- 29.1 mg/kg IBM, p = 0.002) as well as calorie delivered from protein (I - 0.22 +/- 0.04, II - 0.26 +/- 0.07%, p = 0.001) and carbohydrates (I - 0.79 +/- 0.15, II - 0.94 +/- 0.21, p = 0.000) in relation to total amount of ingested calorie. Group I showed significantly lower serum levels of albumin (I - 2.45, 1-3, II - 2.83, 1-3 scores, p = 0.023) and cholesterol (I - 5.54 +/- 1.06, II - 6.35 +/- 1.63 mmol/l, p = 0.009), but higher serum iron (I - 16.7 +/- 4.4, II - 15.8 +/- 5.2 micromol/l, p = 0.042) and ferritin (I - 615, 28-5113, II - 377, 24-3376 ng/ml, p = 0.021) concentrations as well as transferrin saturation (I - 31.1 +/- 9.2, II - 28.5 +/- 9.2%, p = 0.032). We conclude that PD patients with Kt/V over 2.0 as compared to those with Kt/V below 2.0 show tendency for better nutritional indices excluding serum iron parameters.
我们研究的目的是评估腹膜透析(PD)充分性与PD患者营养参数之间的关系。完成PD治疗的患者(n = 124),根据整个PD疗程的平均总Kt/V低于2.0(I组)或高于2.0(II组)分为两组。在整个PD疗程中,每3 - 6个月对每位患者评估充分性参数、食品每日摄入量和营养指标。使用所检查参数的平均值来比较两组之间观察到的差异。I组包括63名男性、16名女性,年龄50.3±13.8岁,PD疗程13.2±10.1个月。II组由12名男性、33名女性组成,年龄49.1±14.9岁,PD疗程8.8±6.0个月。由于两组之间在性别分布、透析疗程和理想体重(IBM)方面存在显著差异,因此在对这些参数进行结果调整后进行了统计分析。I组动物蛋白、钠、视黄醇、烟酸、饱和与多不饱和脂肪酸以及胆固醇的每日食物成分摄入量绝对值更高。当将每日食物摄入量按IBM进行标准化时,II组的蛋白质氮呈现量(I组 - 0.92±0.25,II组 - 1.12±0.45 g/kg IBM,p = 0.005)以及植物蛋白摄入量(I组 - 0.29±0.10,II组 - 0.34±0.09 g/kg IBM,p = 0.040)、碳水化合物(I组 - 3.30±1.08,II组 - 3.80±1.34 g/kg IBM,p = 0.029)、钾(I组 - 33.2±10.6,II组 - 38.3±13.2 mg/kg IBM,p = 0.034)、钙(I组 - 5.81±2.46,II组 - 7.20±3.54 mg/kg IBM,p = 0.028)、镁(I组 - 2.86±0.86,II组 - 3.41±1.36 mg/kg IBM,p = 0.004)、β-胡萝卜素(I组22.4±15.8,II组 - 34.9±29.1 mg/kg IBM,p = 0.002)以及蛋白质提供的卡路里(I组 - 0.22±0.04,II组 - 0.26±0.07%,p = 0.001)和碳水化合物(I组 - 0.79±0.15,II组 - 0.94±0.21,p = 0.000)相对于摄入卡路里总量均更高。I组血清白蛋白水平(I组 - 2.45,1 - 3分,II组 - 2.83,1 - 3分,p = 0.023)和胆固醇水平(I组 - 5.54±1.06,II组 - 6.35±1.63 mmol/l,p = 0.009)显著更低,但血清铁(I组 - 16.7±4.4,II组 - 15.8±5.2 μmol/l,p = 0.042)和铁蛋白(I组 - 615,28 - 5113,II组 - 377,24 - 337 ng/ml,p = 0.)浓度以及转铁蛋白饱和度(I组 - 31.1±9.2,II组 - 28±9.2%,p = 0.032)更高。我们得出结论,与Kt/V低于2.0的PD患者相比,Kt/V高于2.0的PD患者除血清铁参数外,营养指标有更好的趋势。