Martínez Villaescusa María, León Sanz Miguel, Aguado García Ángel, Pedrón Megías Asunción, Martínez Díaz Mercedes, Gonzalvo Díaz César, García Arce Llanos, Pérez Rodríguez Ana, Gimenez Bachs Jose Miguel, Azaña Rodríguez Abigail, González Martínez Ana Belén, García Martínez Clara, Gómez Roldán Carmen, Botella Romero Francisco
Hospital General Universitario de Albacete.
Hospital Universitario 12 de Octubre.
Nutr Hosp. 2019 Aug 26;36(4):898-904. doi: 10.20960/nh.02576.
Introduction: the strict dietary recommendations we impose on patients with advanced chronic kidney disease (ACKD) have negative impact on quality of life. Objective: determine whether such restrictions are justified and if an educational program can improve health-related quality of life (HRQL) parameters. Methods: we carried out an educational intervention, single center, randomized, controlled clinical trial on ACKD outpatients in Albacete. Seventy-five patients were included, 35 in the control group and 40 in the intervention group. Nutritional assessment was based on the Subjetive Global Assessment (SGA) and body mass index (BMI). We used the SF-36 health questionnaire to measure HRQL. In the intervention group we carried out individual, collective and telephone nutritional interventions, adapting diet advice and restrictions in a personalized way. Results: malnutrition measured by Subjective Global Assessment (SGA) in the control group was 20%; meanwhile, in the intervention group it was 29.3% and it improved at the end of the study, but not significantly. BMI showed overweight with a mean of 28.83 kg/m² (DE: 5.4) and 26.96 kg/m² (DE: 4.09), respectively, and did not change throughout the study. The nutritional intervention improved the score in all the subscales except for body pain score. Besides, mental and physical components also improved their scores in the intervention group and worsened them in the control group (p < 0.001). Conclusions: quality of life can be improved in ACKD patients applying an educational nutrition program.
我们对晚期慢性肾脏病（ACKD）患者实施的严格饮食建议对生活质量有负面影响。目的：确定这些限制是否合理，以及一项教育计划能否改善健康相关生活质量（HRQL）参数。方法：我们在阿尔巴塞特对ACKD门诊患者进行了一项单中心、随机、对照的教育干预临床试验。纳入75例患者，35例为对照组，40例为干预组。营养评估基于主观全面评定法（SGA）和体重指数（BMI）。我们使用SF-36健康问卷来测量HRQL。在干预组，我们进行了个体、集体和电话营养干预，以个性化方式调整饮食建议和限制。结果：对照组通过主观全面评定法（SGA）测得的营养不良率为20%；同时，干预组为29.3%，且在研究结束时有所改善，但不显著。BMI显示超重，平均值分别为28.83kg/m²（标准差：5.4）和26.96kg/m²（标准差：4.09），且在整个研究过程中没有变化。营养干预使除身体疼痛评分外的所有子量表得分均有所提高。此外，干预组的心理和生理成分得分也有所提高，而对照组则有所下降（p<0.001）。结论：应用教育性营养计划可改善ACKD患者的生活质量。
