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个性化营养干预方案对血液透析患者营养状况、生活质量及死亡率的影响

Effect of a personalized nutritional intervention program on nutritional status, quality of life and mortality in hemodialysis patients.

作者信息

Visiedo Lucía, López Francisca, Rivas-Ruiz Francisco, Tortajada Begoña, Giménez Martínez Rafael, Abilés Jimena

机构信息

Pharmacy and Nutrition Unit. Hospital Universitario Costa del Sol.

Nephrology Unit. Hospital Universitario Costa del Sol.

出版信息

Nutr Hosp. 2023 Dec 14;40(6):1229-1235. doi: 10.20960/nh.04756.

DOI:10.20960/nh.04756
PMID:37705451
Abstract

Objective: dietary advice provided through a nutritional intervention program (NIP) is recommended by renal clinic guidelines to prevent or treat malnutrition, that could improve quality of life (QoL) and survival in hemodialysis (HD) patients. This study set out to evaluate the effect of a personalized NIP on the nutritional status and its impact on QoL and mortality in dialyzed patients. Material and methods: this was a 12-month intervention study with regular follow-up in which nutritional parameters were measured at baseline and after 6 and 12 months. QoL was assessed by the Kidney Disease Quality of Life version 1.2 (KDQOL-SF) at baseline and at the end of the study. All dialyzed patients received individualized consultations with a trained dietitian. The content of the nutritional education program included a personalized meal plan and educational materials addressing nutrition to manage fluids, electrolytes, and vitamin D. Results: a total of 75 patients were included. After the NIP, visceral proteins, phosphorous, potassium and vitamin D levels had improved significantly (p < 0.001). The percentage of well-nourished patients increased by 30 % (p < 0.001). At the end of the study, the well-nourished patients had significantly improved scores on the general summary areas of the KDQOL-SF, reduced worry concerning fluid and dietary restrictions (p < 0.001), and the survival rate was 12 months longer (p < 0.01). Conclusion: the results of this study suggest that personalized NIP contributed to improved nutritional status, QoL and survival in HD patients.

摘要

目的

肾脏科临床指南推荐通过营养干预计划(NIP)提供饮食建议,以预防或治疗营养不良,这可能改善血液透析(HD)患者的生活质量(QoL)和生存率。本研究旨在评估个性化NIP对透析患者营养状况的影响及其对QoL和死亡率的影响。材料与方法:这是一项为期12个月的干预研究,定期进行随访,在基线以及6个月和12个月后测量营养参数。在基线和研究结束时通过肾脏疾病生活质量量表1.2版(KDQOL-SF)评估QoL。所有透析患者均接受了由训练有素的营养师进行的个性化咨询。营养教育计划的内容包括个性化饮食计划和有关管理液体、电解质和维生素D的营养教育材料。结果:共纳入75例患者。NIP实施后,内脏蛋白、磷、钾和维生素D水平显著改善(p < 0.001)。营养良好患者的比例增加了30%(p < 0.001)。在研究结束时,营养良好的患者在KDQOL-SF的总体总结领域得分显著提高,对液体和饮食限制的担忧减少(p < 0.001),生存率延长了12个月(p < 0.01)。结论:本研究结果表明,个性化NIP有助于改善HD患者的营养状况、QoL和生存率。

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