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在肾移植受者中,饮食营养素摄入和肾小球滤过率的 5 年变化。

Changes in Dietary Nutrient Intake and Estimated Glomerular Filtration Rate over a 5-Year Period in Renal Transplant Recipients.

机构信息

Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan.

出版信息

Nutrients. 2023 Dec 31;16(1):148. doi: 10.3390/nu16010148.

Abstract

The scarcity of dietary guidance for renal transplant recipients (RTRs) raises concerns regarding obesity and associated comorbidities, including impaired renal function. This two-stage cross-sectional study examined longitudinal changes in dietary nutrient intake in the same individuals over a 5-year interval. This study involved two stages: T1 (September 2016 to June 2018) and T2 (July 2022 to August 2023). The average duration between the two data collection stages was 6.17 ± 0.42 (range 5.20-6.87) years. The study included 227 RTRs with an average age and time since transplant of 49.97 ± 12.39 and 9.22 ± 7.91 years, respectively. Of the 35 patients who participated in both phases, fewer than half met the recommended intakes for energy, dietary fiber, and most vitamins and minerals, as set in the Dietary Reference Intakes (DRIs) or by the Dietitian Association Australia (DAA). Over half exceeded the DRI recommended intake for total protein, and more than 80% of the protein consumed per kilogram of body weight exceeded the DAA's recommendations. In the T2 stage, the RTRs had a significantly higher blood urea nitrogen level, lower albumin level, and estimated glomerular filtration rate. These findings indicate that deteriorating dietary intake in RTRs can adversely affect their nutritional status and transplanted kidney function over a 5-year period.

摘要

肾移植受者(RTR)的饮食指导稀缺,这令人担忧肥胖及其相关合并症,包括肾功能受损。这项两阶段横断面研究在 5 年的时间内,在相同个体中检查了饮食营养素摄入的纵向变化。这项研究包括两个阶段:T1(2016 年 9 月至 2018 年 6 月)和 T2(2022 年 7 月至 2023 年 8 月)。两次数据收集阶段之间的平均时间间隔为 6.17±0.42 年(范围为 5.20-6.87 年)。该研究包括 227 名 RTR,平均年龄和移植后时间分别为 49.97±12.39 岁和 9.22±7.91 年。在参加了两个阶段的 35 名患者中,不到一半的患者满足了能量、膳食纤维和大多数维生素和矿物质的推荐摄入量,这些摄入量是根据饮食参考摄入量(DRIs)或澳大利亚营养师协会(DAA)设定的。超过一半的患者超过了 DRI 推荐的总蛋白摄入量,每公斤体重摄入的蛋白质超过了 DAA 的建议。在 T2 阶段,RTR 的血尿素氮水平显著升高,白蛋白水平降低,肾小球滤过率估计值降低。这些发现表明,RTR 饮食摄入的恶化可能会在 5 年内对其营养状况和移植肾脏功能产生不利影响。

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