Moreira Ana Catarina, Carolino Elisabete, Domingos Fernando, Gaspar Augusta, Ponce Pedro, Camilo María Ermelinda
Escola Superior de Tecnologia da Saúde de Lisboa, Lisboa, Portugal.
Nutr Hosp. 2013 May-Jun;28(3):951-7. doi: 10.3305/nh.2013.28.3.6454.
Poor nutritional status and worse healthrelated quality of life (QoL) have been reported in haemodialysis (HD) patients. The utilization of generic and disease specific QoL questionnaires in the same population may provide a better understanding of the significance of nutrition in QoL dimensions.
To assess nutritional status by easy to use parameters and to evaluate the potential relationship with QoL measured by generic and disease specific questionnaires.
Nutritional status was assessed by subjective global assessment adapted to renal patients (SGA), body mass index (BMI), nutritional intake and appetite. QoL was assessed by the generic EuroQoL and disease specific Kidney Disease Quality of Life-Short Form (KDQoL-SF) questionnaires.
The study comprised 130 patients of both genders, mean age 62.7 ± 14.7 years. The prevalence of undernutrition ranged from 3.1% by BMI ≤ 18.5 kg/m² to 75.4% for patients below energy and protein intake recommendations. With the exception of BMI classification, undernourished patients had worse scores in nearly all QoL dimensions (EuroQoL and KDQoL-SF), a pattern which was dominantly maintained when adjusted for demographics and disease-related variables. Overweight/ obese patients (BMI ≥ 25) also had worse scores in some QoL dimensions, but after adjustment the pattern was maintained only in the symptoms and problems dimension of KDQoL-SF (p = 0.011).
Our study reveals that even in mildly undernourished HD patients, nutritional status has a significant impact in several QoL dimensions. The questionnaires used provided different, almost complementary perspectives, yet for daily practice EuroQoL is simpler. Assuring a good nutritional status, may positively influence QoL.
据报道,血液透析(HD)患者存在营养状况不佳和健康相关生活质量(QoL)较差的情况。在同一人群中使用通用和特定疾病的QoL问卷,可能有助于更好地理解营养在QoL维度中的重要性。
通过易于使用的参数评估营养状况,并评估其与通过通用和特定疾病问卷测量的QoL之间的潜在关系。
通过适用于肾病患者的主观全面评定法(SGA)、体重指数(BMI)、营养摄入量和食欲来评估营养状况。通过通用的欧洲生活质量量表(EuroQoL)和特定疾病的肾脏病生活质量简表(KDQoL-SF)问卷来评估QoL。
该研究纳入了130名患者,男女均有,平均年龄62.7±14.7岁。营养不良的患病率从BMI≤18.5kg/m²时的3.1%到能量和蛋白质摄入量低于推荐值的患者中的75.4%不等。除BMI分类外,营养不良的患者在几乎所有QoL维度(EuroQoL和KDQoL-SF)中的得分都较低,在对人口统计学和疾病相关变量进行调整后,这种模式基本保持不变。超重/肥胖患者(BMI≥25)在某些QoL维度中的得分也较低,但调整后这种模式仅在KDQoL-SF的症状和问题维度中保持(p=0.011)。
我们的研究表明,即使在轻度营养不良的HD患者中,营养状况对几个QoL维度也有显著影响。所使用的问卷提供了不同的、几乎互补的观点,但在日常实践中,EuroQoL更简单。确保良好的营养状况可能会对QoL产生积极影响。