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撒哈拉以南非洲某国接受维持性血液透析治疗患者的饮食摄入与营养状况横断面分析

A Cross-Sectional Analysis of Dietary Intake and Nutritional Status of Patients on Haemodialysis Maintenance Therapy in a Country of Sub-Saharan Africa.

作者信息

Gityamwi Nyangi A, H Hart Kathryn, Engel Barbara

机构信息

Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.

出版信息

Int J Nephrol. 2021 May 15;2021:1826075. doi: 10.1155/2021/1826075. eCollection 2021.

Abstract

Malnutrition is common among dialysis patients, but there is insufficient literature on the problem from resource-poor settings of the sub-Saharan region. We conducted a cross-sectional investigation of dietary intake and nutritional status of haemodialysis (HD) patients to inform the current status of this population group in the region. HD patients aged ≥18 years, with dialysis vintage of ≥3 months, at one nephrology unit in Tanzania were assessed for their habitual diet and nutrient intake. Anthropometric measures and biochemistry tests were also performed. The diet was predominantly starchy food based, accompanied by a limited selection of vegetables. Fruits and animal protein were also minimally consumed (1 portion/day each). Fruit consumption was higher in females than males (median (25, 75) = 2 (1, 2.3) versus 0.5 (0, 1.7) portions,  = 0.008). More than 70% of participants had suboptimal measures for protein and energy intake, dietary iron, serum albumin, muscle mass, and hand grip strength (HGS). Inadequacies in protein and energy intake and dialysis clearance (URR) increased with the increase in body weight/BMI and other specific components (MAMC and FMI). Consumption of red meats correlated significantly and positively with serum creatinine ( = 0.46,  = 0.01), potassium ( = 0.39,  = 0.03), and HGS ( = 0.43,  = 0.02) and was approaching significance for a correlation with serum iron ( = 0.32,  = 0.07). C-RP correlated negatively with albumin concentration ( = -0.32,  = 0.02), and participants with C-RP within acceptable ranges had significantly higher levels of haemoglobin ( = 0.03, effect size = -0.28). URR correlated negatively with haemoglobin concentration ( = -0.36,  = 0.02). Patients will benefit from improved nutritional services that deliver individually tailored and culturally practical dietary advice to enable them to make informed food choices whilst optimizing disease management.

摘要

营养不良在透析患者中很常见,但撒哈拉以南地区资源匮乏环境下关于这一问题的文献不足。我们对血液透析(HD)患者的饮食摄入和营养状况进行了横断面调查,以了解该地区这一人群的现状。对坦桑尼亚一家肾脏病科≥18岁、透析龄≥3个月的HD患者的日常饮食和营养摄入进行了评估。还进行了人体测量和生化检测。饮食主要以淀粉类食物为主,蔬菜种类有限。水果和动物蛋白的摄入量也很少(各为每天1份)。女性的水果摄入量高于男性(中位数(25,75)=2(1,2.3)份对0.5(0,1.7)份,P=0.008)。超过70%的参与者在蛋白质和能量摄入、膳食铁、血清白蛋白、肌肉量和握力(HGS)方面的指标不理想。蛋白质和能量摄入不足以及透析清除率(URR)随着体重/BMI和其他特定成分(MAMC和FMI)的增加而增加。红肉的摄入量与血清肌酐(P=0.46,r=0.01)、钾(P=0.39,r=0.03)和HGS(P=0.43,r=0.02)显著正相关,与血清铁的相关性接近显著(P=0.32,r=0.07)。C反应蛋白(C-RP)与白蛋白浓度呈负相关(P=-0.32,r=0.02),C-RP在可接受范围内的参与者血红蛋白水平显著更高(P=0.03,效应量=-0.28)。URR与血红蛋白浓度呈负相关(P=-0.36,r=0.02)。患者将受益于改善的营养服务,这些服务提供个性化且符合文化实际的饮食建议,使他们能够在优化疾病管理的同时做出明智的食物选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/911c/8147542/924e1d3743ad/IJN2021-1826075.001.jpg

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