Lai Silvia, Amabile Maria Ida, Altieri Silvia, Mastroluca Daniela, Lai Carlo, Aceto Paola, Crudo Massimiliano, D'Angelo Anna Rita, Muscaritoli Maurizio, Molfino Alessio
Department of Clinical Medicine, Sapienza University of Rome , Rome , Italy.
Department of Clinical and Molecular Medicine, Sapienza University of Rome, UOC Nephrology, Sant' Andrea Hospital , Rome , Italy.
Front Nutr. 2017 Mar 17;4:4. doi: 10.3389/fnut.2017.00004. eCollection 2017.
Chronic kidney disease is a common condition in the general population, particularly among older adults. Renal impairment is in turn associated with metabolic and nutritional derangements and with increased risk of cardiovascular disease.
To compare the metabolic, nutritional, and cardiovascular impact of reduced kidney function between patients with and without known renal disease.
We enrolled consecutive outpatients (age ≥65 years) with reduced renal function who were divided into two groups: Group A with history of renal disease and Group B with unknown renal disease. Metabolic and nutritional parameters, including involuntary body weight loss (BWL) in the previous 6 months, mineral metabolism, inflammatory indices, and left ventricular mass index (LVMI), were evaluated.
A total of 76 patients were enrolled. Group A ( = 39, M: 24, F: 15) showed greater BWL with a significant reduction of 25-hydroxyvitamin D, transferrin, cholinesterase, albumin, and greater [corrected] LVMI with respect to Group B (n = 37, M: 23, F: 14) ( < 0.01). In addition, Group A [corrected] showed significantly increased intact parathyroid hormone, total cholesterol, low-density lipoprotein, triglycerides, and C-reactive protein when compared to Group B [corrected] ( < 0.05).
The positive history of renal disease may negatively impact on several metabolic and nutritional parameters related to increased cardiovascular risk among older adults.
慢性肾脏病在普通人群中很常见，尤其是在老年人中。肾功能损害反过来又与代谢和营养紊乱以及心血管疾病风险增加有关。
比较有和没有已知肾脏疾病的患者肾功能降低对代谢、营养和心血管的影响。
我们纳入了肾功能降低的连续门诊患者（年龄≥65岁），将其分为两组：A组有肾脏疾病史，B组肾脏疾病情况不明。评估了代谢和营养参数，包括前6个月的非自愿体重减轻（BWL）、矿物质代谢、炎症指标和左心室质量指数（LVMI）。
共纳入76例患者。与B组（n = 37，男：23例，女：14例）相比，A组（n = 39，男：24例，女：15例）的BWL更高，25-羟维生素D、转铁蛋白、胆碱酯酶、白蛋白显著降低，[校正后]LVMI更高（P < 0.01）。此外，与B组[校正后]相比，A组[校正后]的完整甲状旁腺激素、总胆固醇、低密度脂蛋白、甘油三酯和C反应蛋白显著升高（P < 0.05）。
肾脏疾病史可能对老年人中与心血管风险增加相关的多个代谢和营养参数产生负面影响。
