Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico.
Health Care Department, Autonomous Metropolitan University, Mexico City 04960, Mexico.
Nutrients. 2018 Mar 29;10(4):425. doi: 10.3390/nu10040425.
Gastrointestinal symptoms (GIS) are common in patients with end-stage renal disease (ESRD) and are associated with nutritional risks resulting from low food intake. Little is known about the relationship between GIS and malnutrition in geriatric patients with ESRD. The main objective of this study was to determine the relationship between nutritional status and severity of GIS in geriatric patients on dialysis therapy. Clinically-stable geriatric patients (older than 60 years old) who were dialysis outpatients were included in this cross-sectional study. The severity of GIS was assessed using the Gastrointestinal Symptoms Questionnaire (GSQ, short version), with patients classified into three groups: mild, moderate, and severe. Nutritional status was evaluated with the Malnutrition Inflammation Score (MIS), anthropometric assessment, biochemical parameters, and bioelectrical impedance. Descriptive statistics were used and differences between groups were analyzed with ANOVA and Kruskal Wallis, with a < 0.05 considered to indicate significance. Fifty patients completed the study; the median age was 67 years old. Twenty-three patients were on hemodialysis (HD) and 27 were on peritoneal dialysis (PD). No significant differences were found according to dialysis modality, presence of diabetes, or gender. Ninety percent of patients had at least one GIS. Poorer nutritional status (evaluated by MIS) was related to a higher severity of GIS. There were no significant differences with other nutritional parameters. Our study showed a high prevalence of GIS in geriatric patients. There were no differences in observed GIS values that were attributed to dialysis modality, gender, or presence of type 2 diabetes mellitus (DM2). Severe GIS values were associated with poorer nutritional status determined by MIS, however, there was no association with anthropometry, biochemical values, or bioimpedance vector analysis.
胃肠道症状（GIS）在终末期肾病（ESRD）患者中很常见，与低食物摄入导致的营养风险有关。关于老年 ESRD 患者 GIS 与营养不良之间的关系知之甚少。本研究的主要目的是确定透析治疗的老年患者营养状况与 GIS 严重程度之间的关系。本横断面研究纳入了临床稳定的老年（年龄大于 60 岁）透析门诊患者。使用胃肠道症状问卷（GSQ，简短版）评估 GIS 的严重程度，患者分为三组：轻度、中度和重度。使用营养不良炎症评分（MIS）、人体测量评估、生化参数和生物电阻抗评估营养状况。采用描述性统计方法，组间差异采用 ANOVA 和 Kruskal Wallis 分析， < 0.05 表示差异有统计学意义。五十名患者完成了研究；中位年龄为 67 岁。23 名患者接受血液透析（HD），27 名患者接受腹膜透析（PD）。透析方式、是否患有糖尿病或性别之间没有差异。90%的患者至少有一种 GIS。营养不良程度（用 MIS 评估）较差与 GIS 严重程度较高有关。与其他营养参数无显著差异。我们的研究显示，老年患者 GIS 的患病率很高。观察到的 GIS 值与透析方式、性别或 2 型糖尿病（DM2）的存在无关。严重 GIS 值与 MIS 确定的较差营养状况有关，但与人体测量、生化值或生物阻抗向量分析无关。
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