Alfonso A I-Q, Castillo R F, Gomez Jimenez F J, Nuñez Negrillo A M
Universidad de Granada, Facultad de Ciencias de la Salud, Campus de Ceuta, C/ Cortadura del Valle SN. CP 51001, Ceuta, Spain.
School of Health Sciences, University of Granada, Ceuta, Spain.
West Indian Med J. 2015 Jun;64(3):213-7. doi: 10.7727/wimj.2014.117. Epub 2015 May 5.
Protein-energy malnutrition as well as systemic inflammation and metabolic disorders are common in patients with chronic kidney failure, who require renal replacement therapy (haemodialysis). Such malnutrition is a factor that significantly contributes to their morbidity and mortality. This study evaluated the nutritional status of haemodialysis patients by assessing biochemical and anthropometric parameters in order to determine whether these patients suffered disorders reflecting nutritional deterioration directly related to time on haemodialysis.
This research comprised 90 patients of both genders with chronic kidney failure, who regularly received haemodialysis at our unit over a period of ten years. The patients' blood was tested quarterly for plasma albumin, total cholesterol and total proteins, and tested monthly for transferrin. The patients' weight, height and body mass index (BMI) were monitored. Body mass index was calculated using the formula: weight (kg)/height (m2 ) and classified in one of the following categories defined in the World Health Organization (WHO) Global Database on Body Mass Index: (i) underweight [BMI < 18.50], (ii) normal [BMI 18.50 - 24.99], (iii) overweight [BMI 25 - 29.99], (iv) obese [BMI > 30].
In the ten-year period of the study, the patients experienced a substantial decline in their biochemical parameters. Nevertheless, their BMI did not show any significant changes despite the patients' state of malnutrition.
The prevalence of malnutrition in haemodialysis patients was evident. Nevertheless, the BMI of the subjects did not correspond to the biochemical parameters measured. Consequently, the results showed that the nutritional deterioration of these patients was mainly reflected in their biochemical parameters rather than in their anthropometric measurements.
蛋白质能量营养不良以及全身炎症和代谢紊乱在需要肾脏替代治疗（血液透析）的慢性肾衰竭患者中很常见。这种营养不良是导致其发病率和死亡率显著升高的一个因素。本研究通过评估生化和人体测量参数来评估血液透析患者的营养状况，以确定这些患者是否患有反映与血液透析时间直接相关的营养恶化的疾病。
本研究包括90例患有慢性肾衰竭的男女患者，他们在我们科室定期接受血液透析达十年之久。每季度检测患者血液中的血浆白蛋白、总胆固醇和总蛋白，每月检测转铁蛋白。监测患者的体重、身高和体重指数（BMI）。体重指数采用公式计算：体重（千克）/身高（米²），并根据世界卫生组织（WHO）全球体重指数数据库定义的以下类别之一进行分类：（i）体重过轻[BMI < 18.50]，（ii）正常[BMI 18.50 - 24.99]，（iii）超重[BMI 25 - 29.99]，（iv）肥胖[BMI > 30]。
在研究的十年期间，患者的生化参数大幅下降。然而，尽管患者存在营养不良状态，但其BMI并未显示出任何显著变化。
血液透析患者中营养不良的患病率很明显。然而，受试者的BMI与所测量的生化参数并不相符。因此，结果表明这些患者的营养恶化主要反映在其生化参数上，而非人体测量指标上。
