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[一组持续性非卧床腹膜透析患者的营养状况评估]

[Evaluation of nutritional status in a group of patients undergoing CAPD].

作者信息

Viglino G, Gallo M, Cottino R, Gandolfo C, Mariano F, Vallone P, Goia F, Cavalli P L

机构信息

Servizio di Nefrologia e Dialisi, Ospedale S. Lazzaro, Alba, Cuneo.

出版信息

Minerva Urol Nefrol. 1991 Jul-Sep;43(3):217-24.

PMID:1817347
Abstract

The onset of a protein-energy malnutrition represents a real risk for patients on CAPD. In order to verify the nutritional status and the effectiveness of the dietetic surveillance in preventing this complication, dietary intake, anthropometric measurements and biochemical parameters were monitored in 46 patients (27 males, 19 females, mean age: 58.7 +/- 14.8 years), suffering from ESRF and treated with CAPD, for a total observation period of 1731.67 months (mean: 37.64 +/- 25.17 months). The mean glucose concentration in the dialysate was 2.00 +/- 0.36 g/dl, the glucose reabsorption from dialysate per kg of ideal body weight (kg-IBW) was equivalent to 5.1 kcal, the mean dialysate protein loss was 13.08 +/- 5.52 g/day and the incidence of peritonitis episodes was 1 every 30.38 months-patient. The daily total caloric intake (by mouth and dialysate) was 30.8 kcal/kg-IBW with a normal subdivision for each diet component: there were not statistically significant differences in distribution according to age, sex and in the follow-up. The mean daily value of protein intake (PI) evaluated by dietary interviews was 0.99 g/kg-IBW, with a significant increase 1 year since the beginning of CAPD; the PI evaluated from urea nitrogen appearance was 1.22 g/kg-IBW. The PI remained stable later in the follow-up and in patients that made use of dietetic supplements, the mean daily increase by this way was 0.47 g/kg-IBW. Anthropometric measurements showed a statistically significant increase of %RBW after 1 year and of TS and % body fat after 3 years.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

蛋白质 - 能量营养不良的发生对接受持续性非卧床腹膜透析(CAPD)的患者构成了切实风险。为了核实营养状况以及饮食监测在预防该并发症方面的有效性,对46例(27例男性,19例女性,平均年龄:58.7±14.8岁)患有终末期肾衰竭(ESRF)并接受CAPD治疗的患者进行了饮食摄入量、人体测量学指标及生化参数监测,总观察期为1731.67个月(平均:37.64±25.17个月)。透析液中的平均葡萄糖浓度为2.00±0.36 g/dl,每千克理想体重(kg-IBW)从透析液中重吸收的葡萄糖相当于5.1千卡,透析液蛋白质平均丢失量为13.08±5.52 g/天,腹膜炎发作发生率为每30.38个月 - 患者1次。每日总热量摄入(经口和透析液)为30.8千卡/kg-IBW,各饮食成分划分正常:按年龄、性别及随访情况,分布无统计学显著差异。通过饮食访谈评估的蛋白质摄入量(PI)平均每日值为0.99 g/kg-IBW,自CAPD开始1年后显著增加;根据尿素氮表观评估的PI为1.22 g/kg-IBW。在后续随访中PI保持稳定,对于使用饮食补充剂的患者,通过这种方式平均每日增加0.47 g/kg-IBW。人体测量学指标显示,1年后%RBW有统计学显著增加,3年后TS及%体脂有统计学显著增加。(摘要截断于250字)

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