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接受透析治疗的5期慢性肾脏病患者的营养评估。

Nutritional evaluation of stage 5 chronic kidney disease patients on dialysis.

作者信息

Piratelli Cynthia Mauro, Telarolli Junior Rodolpho

机构信息

Medical College, Centro Universitário de Araraquara, São Paulo, Brazil.

出版信息

Sao Paulo Med J. 2012;130(6):392-7. doi: 10.1590/s1516-31802012000600006.

Abstract

CONTEXT AND OBJECTIVE

Patients with chronic kidney failure undergoing dialysis have high prevalence of protein-energy malnutrition. There is still no uniform method for assessing these patients' nutritional status. It is recommended that a set of subjective and objective methods should be applied so that an adequate nutritional diagnosis can be reached. The aim of this study was to evaluate the nutritional profile of patients undergoing hemodialysis.

DESIGN AND SETTING

Cross-sectional study conducted in the Dialysis Treatment Unit, Araraquara, São Paulo, Brazil, in 2008.

METHODS

Anthropometric and biochemical indicators were characterized for 48 patients who also gave responses to the modified Subjective Global Assessment questionnaire (SGAm), and possible correlations between these indicators were investigated.

RESULTS

The frequency of moderate or severe malnutrition ranged from 22% to 54%, according to the parameter used. Regarding the patients' conformity with the ideal weight, 29% of them weighed less than 75% of the ideal, and thus were classified as having moderate or severe malnutrition. The most significant correlations were observed between body mass index (BMI) and the idealness of triceps skinfold (TSF), upper arm circumference (UAC) and upper arm muscle circumference (UAMC); and between SGAm and the idealness of UAC and UAMC.

CONCLUSION

The frequency of malnutrition showed great variability among the patients, according to the evaluation criterion chosen. Routine nutritional monitoring and validation of methods for assessing body composition among such patients are extremely important for diagnosing malnutrition early on, thus preventing complications and reducing the morbidity and mortality rates in this population.

摘要

背景与目的

接受透析治疗的慢性肾衰竭患者蛋白质 - 能量营养不良的患病率很高。目前仍没有统一的方法来评估这些患者的营养状况。建议应用一套主观和客观的方法,以便做出充分的营养诊断。本研究的目的是评估接受血液透析患者的营养状况。

设计与地点

2008年在巴西圣保罗州阿拉拉夸拉市的透析治疗单元进行的横断面研究。

方法

对48例患者进行人体测量和生化指标检测,这些患者还对改良的主观全面评定问卷(SGAm)做出了回答,并研究了这些指标之间可能存在的相关性。

结果

根据所使用的参数,中度或重度营养不良的发生率在22%至54%之间。关于患者与理想体重的符合情况,29%的患者体重低于理想体重的75%,因此被归类为中度或重度营养不良。观察到体重指数(BMI)与三头肌皮褶厚度(TSF)、上臂围(UAC)和上臂肌肉围(UAMC)的理想程度之间;以及SGAm与UAC和UAMC的理想程度之间存在最显著的相关性。

结论

根据所选择的评估标准,患者中营养不良的发生率差异很大。对这类患者进行常规营养监测以及评估身体成分方法的验证对于早期诊断营养不良极为重要,从而预防并发症并降低该人群的发病率和死亡率。

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Nutrition and metabolism in kidney disease.肾脏疾病中的营养与代谢
Semin Nephrol. 2006 Mar;26(2):134-57. doi: 10.1016/j.semnephrol.2005.09.010.
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Anthropometric norms for the dialysis population.透析人群的人体测量规范。
Am J Kidney Dis. 1990 Jul;16(1):32-7. doi: 10.1016/s0272-6386(12)80782-7.

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