Division of Cardiology, Staten Island University Hospital, New York, USA.
J Ren Nutr. 2011 Nov;21(6):438-47. doi: 10.1053/j.jrn.2010.09.001. Epub 2010 Dec 24.
Cardiovascular disease is highly prevalent and has a major effect on morbidity and mortality in patients undergoing maintenance hemodialysis (MHD). Dietary factors that may contribute to cardiovascular disease have not been well studied in this population. We hypothesize that dietary intake in this population does not meet the guidelines for cardiovascular risk reduction.
A cross-sectional study was completed using the validated "Block Dialysis 1 Food Frequency Questionnaire" to assess dietary intake of MHD patients.
A total of 70 patients undergoing MHD at our outpatient dialysis center completed the questionnaire under the supervision of a trained dietitian. The population consisted of 38 men and 32 women.
Dietary intake was the main outcome measure, with a focus on calories, soluble fiber, saturated fatty acid (SFA), unsaturated fatty acid intake (UFA), and protein.
The mean fiber intake was 10.77 (±5.87) g/day, and only 2 of 71 (2.9%) were in compliance with the recommended daily intake of >25 g/day. As percentage of total calories, of the 70 patients, 5 (7.1%) had a fat intake of <30%, 22 (31.4%) had SFA intake of <10%, 64 (91.4%) had a UFA of ≤30%, 22 (31.4%) had a protein-based diet of ≥15%, and 66 (94.3%) had a carbohydrate diet of <60%.
Most patients did not meet the dietary guidelines for reducing the risk of cardiovascular disease. Substituting UFA or soluble fiber for SFA improves low density lipoprotein (LDL) cholesterol levels without negative effects on other lipid parameters.
心血管疾病在接受维持性血液透析（MHD）的患者中发病率高，对发病率和死亡率有重大影响。可能导致心血管疾病的饮食因素在该人群中尚未得到充分研究。我们假设该人群的饮食摄入不符合降低心血管风险的指南。
使用经过验证的“Block Dialysis 1 食物频率问卷”进行了一项横断面研究，以评估 MHD 患者的饮食摄入情况。
我们的门诊透析中心共有 70 名接受 MHD 的患者在经过培训的营养师的监督下完成了问卷。该人群由 38 名男性和 32 名女性组成。
饮食摄入是主要观察指标，重点关注卡路里、可溶性纤维、饱和脂肪酸（SFA）、不饱和脂肪酸（UFA）和蛋白质的摄入量。
平均纤维摄入量为 10.77（±5.87）g/天，只有 71 人中的 2 人（2.9%）符合每日 >25 g 的推荐摄入量。按总卡路里的百分比计算，在 70 名患者中，5 名（7.1%）的脂肪摄入量<30%，22 名（31.4%）的 SFA 摄入量<10%，64 名（91.4%）的 UFA 摄入量≤30%，22 名（31.4%）的蛋白质饮食量≥15%，66 名（94.3%）的碳水化合物饮食量<60%。
大多数患者不符合降低心血管疾病风险的饮食指南。用 UFA 或可溶性纤维替代 SFA 可改善 LDL 胆固醇水平，而对其他脂质参数无不良影响。
