晚期慢性肾病患儿的营养评估——一项单中心研究
Nutrition assessment of children with advanced stages of chronic kidney disease-A single center study.
作者信息
Apostolou A, Printza N, Karagiozoglou-Lampoudi T, Dotis J, Papachristou F
机构信息
Clinical Nutrition Lab "Christos Mantzoros", Nutrition Dept, Alexander Technological Education Institute, Thessaloniki, Greece.
Pediatric Department, Medical Faculty, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Hippokratia. 2014 Jul-Sep;18(3):212-6.
BACKGROUND
Malnutrition is a major problem among children with Chronic Kidney Disease (CKD) and it is essential to be recognized as early as possible. Aim of our study was to assess the nutrition status of children with CKD.
METHODS
Nutrition status of 30 children (1-16 years) with CKD stages IIIV and on peritoneal dialysis was evaluated. Malnutrition risk was assessed by Pediatric Digital Scaled MAlnutrition Risk screening Tool (PeDiSMART) score software.Anthropometry was expressed as Z-scores for age and sex. Phase angle (PhA) and body cell mass were assessed by bioelectrical impedance analysis (BIA). Three-day food intake was recorded and analyzed. Biochemical indexes were assessed.
RESULTS
Depending on the marker used for assessment 20-40% of our patients were malnourished. Intake/requirements ratio (median) was 86.5% for actual energy intake and 127% for actual protein intake. Multiple regression analysis has shown that the most determinant factor for Mid Upper Arm Circumference (MUAMC) was actual protein intake, Glomerular Filtration Rate (GFR) and age at diagnosis. PhA was mainly affected by GFR and energy intake. Statistically significant inverse correlation was found between PeDiSMART score and PhA (p=0.001), MUAMC (p=0.008) as well as protein intake (p=0.016).
CONCLUSIONS
A considerable proportion of children with advanced CKD are undernourished. Regular dietitian evaluation based on novel tools as PeDiSMART score and PhA may identify earlier patients at risk for malnutrition. Hippokratia 2014; 18 (3): 212-216.
背景
营养不良是慢性肾脏病（CKD）患儿中的一个主要问题，尽早识别至关重要。我们研究的目的是评估CKD患儿的营养状况。
方法
对30名年龄在1至16岁、处于CKD III - IV期且接受腹膜透析的患儿的营养状况进行评估。采用儿童数字量表营养不良风险筛查工具（PeDiSMART）评分软件评估营养不良风险。人体测量指标用年龄和性别的Z评分表示。通过生物电阻抗分析（BIA）评估相角（PhA）和身体细胞质量。记录并分析三天的食物摄入量。评估生化指标。
结果
根据用于评估的指标，20% - 40%的患者存在营养不良。实际能量摄入量的摄入/需求比（中位数）为86.5%，实际蛋白质摄入量为127%。多元回归分析表明，对中上臂围（MUAMC）影响最大的因素是实际蛋白质摄入量、肾小球滤过率（GFR）和诊断时年龄。PhA主要受GFR和能量摄入量影响。在PeDiSMART评分与PhA（p = 0.001）、MUAMC（p = 0.008）以及蛋白质摄入量（p = 0.016）之间发现了具有统计学意义的负相关。
结论
相当一部分晚期CKD患儿营养不良。基于PeDiSMART评分和PhA等新工具进行定期营养师评估，可能更早地识别出有营养不良风险的患者。《希波克拉底》2014年；18（3）：212 - 216。
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