营养干预对延缓老年慢性肾脏病患者进入透析阶段时间的有效性——一项回顾性队列研究
Nutritional Intervention Effectiveness on Slowing Time to Dialysis in Elderly Patients with Chronic Kidney Disease-A Retrospective Cohort Study.
作者信息
Perna Simone, Faisal Fatima, Spadaccini Daniele, Alalwan Tariq A, Ilyas Zahra, Gasparri Clara, Rondanelli Mariangela
机构信息
Department of Biology, College of Science, Sakhir Campus, University of Bahrain, Zallaq 32038, Bahrain.
Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
出版信息
Geriatrics (Basel). 2022 Aug 13;7(4):83. doi: 10.3390/geriatrics7040083.
BACKGROUND
Chronic kidney disease (CKD) is a global health issue. Evidence of the effectiveness of nutritional intervention on slowing time to dialysis is limited in Arab countries. Therefore, this study aims to contribute to current research by providing new insights on the efficacy of personalized nutritional intervention in pre-dialysis patients in the Kingdom of Bahrain.
METHODS
This retrospective cohort study included 265 CKD patients (163 males and 108 females) who were admitted to the nephrology outpatient clinic at Salmaniya Medical Complex in Bahrain. The nutritional intervention group (NIG) receiving dietary advice by an expert renal dietitian consisted of 121 patients, while the non-nutritional intervention control group (non-NIG) that did not receive any nutritional support consisted of 150 patients. Patients were evaluated at baseline and follow-up.
RESULTS
The NIG had a significant increase in the estimated glomerular filtration rate (eGFR) compared to the non-NIG that had a significant decrease (5.16 vs. -2.85 mL/min/1.73 m ( = 0.000), respectively). When adjusted for age and gender, the mean difference was greater (8.0 mL/min/1.73 m, = 0.000). Additionally, there was a significant reduction in blood urea nitrogen and serum creatinine (-2.19 mmol/L and -25.31 µmol/L; = 0.000, respectively). Moreover, the intervention had a positive impact on weight loss and body mass index (-1.84 kg and-0.69 kg/m, respectively; = 0.000) and lipid profile, with a significant reduction in total cholesterol and triglyceride levels (-0.17 mmol/L, = 0.006 and -0.15 mmol/L, = 0.026, respectively). Additional significant results from the NIG included reduced uric acid (-28.35 µmol/L, = 0.006), serum phosphorus (-0.05 mol/L, = 0.025), fasting blood glucose (-0.70 mmol/L, = 0.016) and glycated hemoglobin (1.10 mmol/mol, = 0.419).
CONCLUSIONS
This study suggests that, in patients of CKD, nutritional intervention counselling plays a significant role in reducing the time needed for dialysis and improves nutritional-related biomarkers compared to patients not receiving this intervention.
背景
慢性肾脏病（CKD）是一个全球性的健康问题。在阿拉伯国家，关于营养干预对延缓透析时间有效性的证据有限。因此，本研究旨在通过提供关于巴林王国透析前患者个性化营养干预疗效的新见解，为当前研究做出贡献。
方法
这项回顾性队列研究纳入了265例CKD患者（163例男性和108例女性），他们均入住巴林萨勒曼尼亚医疗中心的肾脏病门诊。接受专业肾脏营养师饮食建议的营养干预组（NIG）由121例患者组成，而未接受任何营养支持的非营养干预对照组（非NIG）由150例患者组成。在基线和随访时对患者进行评估。
结果
与显著下降的非NIG相比，NIG的估计肾小球滤过率（eGFR）显著增加（分别为5.16 vs. -2.85 mL/min/1.73 m²，P = 0.000）。在对年龄和性别进行调整后，平均差异更大（8.0 mL/min/1.73 m²，P = 0.000）。此外，血尿素氮和血清肌酐显著降低（分别为-2.19 mmol/L和-25.31 µmol/L；P = 0.000）。此外，该干预对体重减轻和体重指数有积极影响（分别为-1.84 kg和-0.69 kg/m²；P = 0.000）以及血脂谱，总胆固醇和甘油三酯水平显著降低（分别为-0.17 mmol/L，P = 0.006和-0.15 mmol/L，P = 0.026）。NIG的其他显著结果包括尿酸降低（-28.35 µmol/L，P = 0.006）、血清磷降低（-0.05 mmol/L，P = 0.025）、空腹血糖降低（-0.70 mmol/L，P = 0.016）和糖化血红蛋白降低（-1.10 mmol/mol，P = 0.419）。
结论
本研究表明，在CKD患者中，与未接受该干预的患者相比，营养干预咨询在减少透析所需时间和改善营养相关生物标志物方面发挥着重要作用。
Zotero 插件