Manandhar D N, Chhetri P K, Pahari L R, Tiwari R, Chowdhary S K
Nephrology Section, Department of Medicine, Nepal Medical College Teaching Hospital, Jorpati, Kathmandu, Nepal.
Nepal Med Coll J. 2008 Sep;10(3):164-9.
Malnutrition is very common in hemodialysis patients and is predisposed by many factors. Malnutrition is associated with increased morbidity and mortality. Total of 26 patients (16 males and 10 females) who were under hemodialysis in our center were included in the study. With the help of Malnutrition Score (MS) developed by Kalanter-Zadeh, nutritional status of the patients was assessed. Patients also underwent different anthropometric measurements such as Body Mass Index (BMI), Triceps skin fold thickness (TSF), Mid Arm Circumlference (MAC) and Mid Arm Muscle Circumference (MAMC) and laboratory investigations. Mean age of the study population was 42.58 +/- 16.32 years (range 19 to 74 years). Females were older than males. MS of the study population was 15.82 +/- 3.76 (range 9-24). Female patients were having higher MS than males (16.5 +/- 4.11 vs. 15.06 +/- 3.55). Based on MS, 22 patients (84.6%) had mild to moderate malnutrition, 2 (7.7%) patients were having severe malnutrition and remaining 2 (7.7%) had normal nutrition score. Females were having lower BMI, MAC and MAMC but higher value of TSF. Significant negative correlation was present between MS and weight, BMI, MAC and MAMC. Calculated Urea Reduction Ratio (URR) of study population was 57.27 +/- 10.89. URR was higher in females than in males (61.77 +/- 12.74 vs. 54.45 +/- 8.85). Only 23.0% of the study population had URR of >65.0%. Protein Catabolic Rate (nPCR) in our study was 0.77 +/- 0.28 g/kg/day. Malnutrition is very common in our center which is >90% when MS was considered. In our study it negatively correlated with weight, BMI, MAC and MAMC. Dialysis inadequacy was present in around 75.0% of our study population.
营养不良在血液透析患者中非常常见，且由多种因素诱发。营养不良与发病率和死亡率的增加相关。本研究纳入了我们中心26例接受血液透析的患者（16例男性和10例女性）。借助Kalanter-Zadeh制定的营养不良评分（MS），评估了患者的营养状况。患者还接受了不同的人体测量，如体重指数（BMI）、肱三头肌皮褶厚度（TSF）、上臂围（MAC）和上臂肌肉围（MAMC）以及实验室检查。研究人群的平均年龄为42.58±(16.32)岁（范围19至74岁）。女性比男性年龄大。研究人群的MS为15.82±(3.76)（范围9 - 24）。女性患者的MS高于男性（16.5±(4.11)对15.06±(3.55)）。根据MS，22例患者（84.6%）有轻度至中度营养不良，2例（7.7%）患者有严重营养不良，其余2例（7.7%）营养评分正常。女性的BMI、MAC和MAMC较低，但TSF值较高。MS与体重、BMI、MAC和MAMC之间存在显著负相关。研究人群计算的尿素清除率（URR）为57.27±(10.89)。女性的URR高于男性（61.77±(12.74)对54.45±(8.85)）。研究人群中只有23.0%的URR＞65.0%。我们研究中的蛋白质分解代谢率（nPCR）为0.77±(0.28)g/kg/天。在我们中心，营养不良非常常见，当考虑MS时超过90%。在我们的研究中，它与体重、BMI、MAC和MAMC呈负相关。我们研究人群中约75.0%存在透析不充分。
