Buchwald R, Peña J C
Department of Nephrology and Mineral Metabolism, Instituto Nacional de la Nutricion Salvador Zubiran, Tlalpan, Mexico.
Perit Dial Int. 1989;9(4):295-301.
We designed this study to evaluate the nutritional conditions of 16 continuous ambulatory peritoneal dialysis (CAPD) patients. In all these patients we did a monthly 1-day clinical, anthropometrical, biochemical, and nitrogen balance evaluation: a minimum of 3 and a maximum of 9 monthly evaluations in all patients. The results were analyzed in two groups: Group I (N = 8) with neutral or positive nitrogen balances, and Group II (N = 8) with one or more negative nitrogen balances. The sex distribution, mean age in years, time on CAPD, and period of study in this protocol were similar in both groups. Group I maintained a positive nitrogen balance and steady values in the anthropometric measurements (triceps fat fold, upper-arm circumference, body weight). Group II showed a significant decrease in both the anthropometric values and the nitrogen balance during the episodes of peritonitis. In this same group, when peritonitis subsided, the protein intake increased, nitrogen balance became positive, and the anthropometric values improved. When all the nutritional evaluations were analyzed we found a significant and direct linear correlation between nitrogen intake and nitrogen balance in g/kg/day (N = 60; nitrogen balance = nitrogen intake x 0.75 - 0.101; r = 0.71; p less than 0.001). We also contrasted the presence of peritonitis with the nitrogen balance and the anthropometric values using Spearman rank correlation coefficient and obtained a very high correlation (0.997 to 0.999). Blood values (blood urea, serum creatinine, serum phosphate, serum potassium, and hemoglobin) were not very sensitive to detect differences within or between groups along the study.(ABSTRACT TRUNCATED AT 250 WORDS)
我们开展这项研究以评估16例持续性非卧床腹膜透析(CAPD)患者的营养状况。对所有这些患者,我们每月进行为期1天的临床、人体测量学、生化及氮平衡评估:所有患者最少进行3次、最多进行9次月度评估。结果分为两组分析:第I组(N = 8)氮平衡为中性或阳性,第II组(N = 8)有一次或多次负氮平衡。两组的性别分布、平均年龄(岁)、CAPD治疗时间及本研究方案中的研究周期相似。第I组保持正氮平衡,人体测量指标(肱三头肌脂肪褶厚度、上臂围、体重)值稳定。第II组在腹膜炎发作期间人体测量值和氮平衡均显著下降。在同一组中,腹膜炎消退后,蛋白质摄入量增加,氮平衡变为正值,人体测量值改善。分析所有营养评估结果时,我们发现氮摄入量与氮平衡(克/千克/天)之间存在显著的直接线性相关性(N = 60;氮平衡 = 氮摄入量×0.75 - 0.101;r = 0.71;p < 0.001)。我们还使用Spearman等级相关系数对比了腹膜炎的存在与氮平衡及人体测量值,得到了非常高的相关性(0.997至0.999)。在整个研究过程中,血液指标(血尿素、血清肌酐、血清磷酸盐、血清钾和血红蛋白)对检测组内或组间差异不太敏感。(摘要截短于250字)