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终末期肾病患者营养参数和静息能量消耗的纵向变化。

Longitudinal changes in nutritional parameters and resting energy expenditure in end-stage renal disease.

机构信息

Faculdade de Medicina, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brasil.

出版信息

J Bras Nefrol. 2020 Mar;42(1):24-30. doi: 10.1590/2175-8239-JBN-2018-0169. Epub 2019 Oct 24.

Abstract

AIMS

To evaluate the nutritional status, resting energy expenditure, caloric and protein intake, and evolution of biochemical parameters in three stages of chronic kidney disease: pre-dialytic, at the beginning of the dialysis treatment, and 30 days after starting treatment.

METHODS

The chi-square and Student's t tests were used to compare the variables, and analysis of repeated measurements was used to compare the data obtained in the three moments evaluated. The results were discussed at the 5% level of significance.

RESULTS

We evaluated 35 patients, 60% female and 60% with diabetes mellitus. There was a decrease in midarm circumference and serum albumin. Inflammatory state and caloric and protein intake increased. There was no significant difference in resting energy expenditure in the three moments. The serum urea and serum albumin, handgrip strength, and protein consumption after 30 days from the start of dialysis were greater in the peritoneal dialysis patients, when compared to the hemodialysis population.

CONCLUSION

there was a decrease in midarm circumference and serum albumin and an increase in protein intake after dialysis. The peritoneal dialysis patients had higher muscle strength, even with lower protein intake. Resting energy expenditure was not different between dialysis methods and the moments evaluated.

摘要

目的

评估慢性肾脏病三个阶段(透析前、透析开始时和开始治疗后 30 天)的营养状况、静息能量消耗、热量和蛋白质摄入以及生化参数的变化。

方法

采用卡方检验和学生 t 检验比较变量,采用重复测量分析比较三个评估时刻获得的数据。结果以 5%的显著性水平进行讨论。

结果

我们评估了 35 名患者,其中 60%为女性,60%患有糖尿病。肱三头肌皮褶厚度和血清白蛋白减少。炎症状态和热量及蛋白质摄入增加。三个时刻的静息能量消耗无显著差异。与血液透析患者相比,腹膜透析患者在开始透析后 30 天时的血清尿素和血清白蛋白、握力和蛋白质摄入量更高。

结论

透析后肱三头肌皮褶厚度和血清白蛋白减少,蛋白质摄入增加。腹膜透析患者的肌肉力量更高,尽管蛋白质摄入量较低。静息能量消耗在透析方法和评估时刻之间没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb71/7213926/95a43731e2ce/2175-8239-jbn-2018-0169-gf01.jpg

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