Department of Clinical Medicine, Botucatu School of Medicine, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil.
Ren Fail. 2010;32(9):1055-9. doi: 10.3109/0886022X.2010.510233.
Some studies suggest that high body mass index (BMI) confers survival advantage in dialysis patients, but BMI does not differentiate muscle from fat mass, and the survival advantage conferred by its increase seems to be limited to patients with high muscle mass. Thus, discriminating body components when evaluating nutritional status and survival is highly important. This study evaluated the influence of nutritional parameters on survival in patients on chronic dialysis.
Anthropometry, bioimpedance, biochemistry, and dietary recall were used to investigate the influence of nutritional parameters on survival in 79 prevalent patients on chronic dialysis.
Protein intake <1.2 g/kg/day and creatinine <9.7 mg/dL were independent predictors of mortality in all patients. Regarding dialysis method, protein intake <1.2 g/kg/day was predictive of mortality among hemodialysis patients, and percent standard mid-arm muscle circumference <80% was identified as a risk factor among peritoneal dialysis patients.
Higher muscle mass, possibly favored by a higher protein intake, conferred survival advantage in dialysis patients.
一些研究表明,高身体质量指数(BMI)为透析患者带来生存优势,但 BMI 并不能区分肌肉和脂肪量,并且其增加带来的生存优势似乎仅限于肌肉量高的患者。因此,在评估营养状况和生存时,区分身体成分非常重要。本研究评估了营养参数对慢性透析患者生存的影响。
使用人体测量学、生物阻抗、生物化学和饮食回忆来调查 79 名慢性透析患者营养参数对生存的影响。
所有患者中,蛋白质摄入量<1.2 g/kg/天和肌酐<9.7 mg/dL 是死亡的独立预测因素。关于透析方法,蛋白质摄入量<1.2 g/kg/天是血液透析患者死亡的预测因素,而标准上臂中部肌肉周长百分比<80%是腹膜透析患者的危险因素。
较高的肌肉量,可能得益于较高的蛋白质摄入量,为透析患者带来了生存优势。