Marckmann P
Department of Medicine, Fredericia Hospital, Denmark.
J Intern Med. 1989 Dec;226(6):429-32. doi: 10.1111/j.1365-2796.1989.tb01419.x.
The relationship between mortality and nutritional status of 48 chronic dialysis patients (32 patients on haemodialysis (HD) and 16 on continuous ambulatory peritoneal dialysis (CAPD)) was studied over a 24-month period. Patients were scored individually according to relative body weight (RBW), S-transferrin, mid-arm muscle circumference (MAMC) and triceps skinfold thickness (TSF), and were given a total score from 0 (normal nutritional status) to 8 (severe protein-caloric malnutrition) at start of observation. The observation period was characterized by a significantly lower total nutritional score among surviving (n = 39) patients than among patients who died (n = 9) (Mann-Whitney, P less than 0.001). There was no difference in mortality between the two kinds of dialysis therapy (HD,CAPD). In conclusion, chronic dialysis patients with a poor nutritional status have a highly increased mortality. The presumably causal nature of this relationship makes prevention of protein-caloric malnutrition among dialysis patients a high priority task.
在24个月的时间里，对48例慢性透析患者（32例血液透析（HD）患者和16例持续性非卧床腹膜透析（CAPD）患者）的死亡率与营养状况之间的关系进行了研究。根据相对体重（RBW）、转铁蛋白、上臂中部肌肉周长（MAMC）和三头肌皮褶厚度（TSF）对患者进行个体评分，并在观察开始时给予从0（营养状况正常）到8（严重蛋白质热量营养不良）的总分。观察期的特点是，存活患者（n = 39）的总营养评分显著低于死亡患者（n = 9）（曼-惠特尼检验，P < 0.001）。两种透析疗法（HD、CAPD）之间的死亡率没有差异。总之，营养状况较差的慢性透析患者死亡率大幅增加。这种关系可能的因果性质使得预防透析患者的蛋白质热量营养不良成为一项高度优先的任务。
