Department of Nutrition and Dietetics, University Hospital Centre Split, 21000 Split, Croatia.
Department of Nephrology and Dialysis, University Hospital Centre Split, 21000 Split, Croatia.
Nutrients. 2022 Aug 29;14(17):3553. doi: 10.3390/nu14173553.
Protein-energy wasting (PEW) is considered one of the major complications of chronic kidney disease (CKD), particularly in dialysis patients. Insufficient energy and protein intake, together with clinical complications, may contribute to the onset and severity of PEW. Therefore, the aim of the study was to analyze the differences in nutritional and hydration status and dietary intake among Dalmatian dialysis patients. Fifty-five hemodialysis (HD) and twenty peritoneal dialysis (PD) participants were included. For each study participant, data about body composition, anthropometric, laboratory, and clinical parameters were obtained. The Malnutrition Inflammation Score (MIS) and two separate 24-h dietary recalls were used to assess nutritional status and dietary intake. The Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) were calculated to compare actual dietary intake with recommended intake. Additionally, the estimated 10-year survival was calculated using the Charlson Comorbidity Index. The prevalence of malnutrition according to MIS was 47.3% in HD and 45% in PD participants. Significant differences in fat tissue parameters were found between HD and PD participants, whereas significant differences in hydration status and muscle mass parameters were not found. A significant difference in NAR between HD and PD participants was noticed for potassium and phosphorus intake, but not for MAR. MIS correlated negatively with anthropometric parameters, fat mass, visceral fat level and trunk fat mass, and iron and uric acid in HD participants, whereas no significant correlations were found in PD participants. The estimated 10-year survival correlated with several parameters of nutritional status in HD and PD participants, as well as nutrient intake in HD participants. These results indicate a high prevalence of malnutrition and inadequate dietary intake in the Dalmatian dialysis population which, furthermore, highlights the urgent need for individualized and structural nutritional support.
蛋白质能量消耗（PEW）被认为是慢性肾脏病（CKD）的主要并发症之一，尤其是在透析患者中。能量和蛋白质摄入不足，加上临床并发症，可能导致 PEW 的发生和严重程度。因此，本研究旨在分析达尔马提亚透析患者的营养和水合状态以及饮食摄入的差异。纳入了 55 名血液透析（HD）和 20 名腹膜透析（PD）患者。对每位研究参与者，都获取了关于身体成分、人体测量学、实验室和临床参数的数据。使用营养不良炎症评分（MIS）和两次单独的 24 小时饮食回忆来评估营养状况和饮食摄入。计算了营养素充足率（NAR）和平均充足率（MAR），以比较实际饮食摄入与推荐摄入。此外，还使用 Charlson 合并症指数计算了估计的 10 年生存率。根据 MIS，HD 组和 PD 组的营养不良患病率分别为 47.3%和 45%。在 HD 和 PD 组之间发现了脂肪组织参数的显著差异，而在水合状态和肌肉质量参数方面没有发现显著差异。在 HD 和 PD 组之间，钾和磷的 NAR 存在显著差异，但 MAR 没有差异。MIS 与 HD 组参与者的人体测量参数、脂肪质量、内脏脂肪水平和躯干脂肪质量以及铁和尿酸呈负相关，而在 PD 组参与者中则未发现显著相关性。估计的 10 年生存率与 HD 和 PD 组参与者的营养状况和营养摄入的几个参数相关。这些结果表明，达尔马提亚透析人群中存在高营养不良患病率和饮食摄入不足的情况，这进一步强调了对个体化和结构性营养支持的迫切需求。
