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非透析慢性肾病患者的饮食摄入:PROGREDIR研究。一项横断面研究。

Dietary intake of non-dialysis chronic kidney disease patients: the PROGREDIR study. A cross-sectional study.

作者信息

Machado Alisson Diego, Anjos Fernanda Silva Nogueira Dos, Domingos Maria Alice Muniz, Molina Maria Del Carmen Bisi, Marchioni Dirce Maria Lobo, Benseñor Isabela Judith Martins, Titan Silvia Maria de Oliveira

机构信息

MSc. Dietitian, Department of Nephrology, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.

Dietitian, Department of Nephrology, Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.

出版信息

Sao Paulo Med J. 2018 May-Jun;136(3):208-215. doi: 10.1590/1516-3180.2017.0177141217. Epub 2018 Jun 18.

Abstract

BACKGROUND

Despite evidence that diet is very important in relation to chronic kidney disease (CKD) progression, studies in this field are scarce and have focused only on some specific nutrients. We evaluated the energy, macronutrient and micronutrient intakes and dietary patterns of non-dialysis CKD participants in the PROGREDIR study.

DESIGN AND SETTING

Cross-sectional study; CKD cohort, São Paulo, Brazil.

METHODS

Baseline data on 454 participants in the PROGREDIR study were analyzed. Dietary intake was evaluated through a food frequency questionnaire. Dietary patterns were derived through principal component analysis. Energy and protein intakes were compared with National Kidney Foundation recommendations. Linear regression analysis was performed between energy and nutrient intakes and estimated glomerular filtration rate (eGFR), and between sociodemographic and clinical variables and dietary patterns.

RESULTS

Median energy and protein intakes were 25.0 kcal/kg and 1.1 g/kg, respectively. In linear regression, protein intake (β = -3.67; P = 0.07) was related to eGFR. Three dietary patterns (snack, mixed and traditional) were retained. The snack pattern was directly associated with male gender (β = 0.27; P = 0.006) and inversely with diabetes (β = -0.23; P = 0.02). The traditional pattern was directly associated with male gender (β = 0.27; P = 0.007) and schooling (β = 0.40; P < 0.001) and inversely with age (β = -0.01; P = 0.001) and hypertension (β = -0.34; P = 0.05).

CONCLUSIONS

We identified low energy and high protein intake in this population. Protein intake was inversely related to eGFR. Dietary patterns were associated with age, gender, schooling level, hypertension and diabetes.

摘要

背景

尽管有证据表明饮食在慢性肾脏病(CKD)进展方面非常重要,但该领域的研究稀缺,且仅聚焦于某些特定营养素。我们在PROGREDIR研究中评估了非透析CKD参与者的能量、宏量营养素和微量营养素摄入量以及饮食模式。

设计与地点

横断面研究;巴西圣保罗的CKD队列。

方法

分析了PROGREDIR研究中454名参与者的基线数据。通过食物频率问卷评估饮食摄入量。通过主成分分析得出饮食模式。将能量和蛋白质摄入量与美国国家肾脏基金会的建议进行比较。对能量和营养素摄入量与估计肾小球滤过率(eGFR)之间,以及社会人口统计学和临床变量与饮食模式之间进行线性回归分析。

结果

能量和蛋白质摄入量中位数分别为25.0千卡/千克和1.1克/千克。在线性回归中,蛋白质摄入量(β = -3.67;P = 0.07)与eGFR相关。保留了三种饮食模式(零食、混合和传统)。零食模式与男性直接相关(β = 0.27;P = 0.006),与糖尿病呈负相关(β = -0.23;P = 0.02)。传统模式与男性直接相关(β = 0.27;P = 0.007)和受教育程度直接相关(β = 0.40;P < 0.001),与年龄呈负相关(β = -0.01;P = 0.001)和高血压呈负相关(β = -0.34;P = 0.05)。

结论

我们发现该人群能量摄入低且蛋白质摄入高。蛋白质摄入量与eGFR呈负相关。饮食模式与年龄、性别、受教育程度、高血压和糖尿病相关。

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