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慢性肾脏病非透析住院患者的营养状况及相关因素:一项单中心混合方法研究

Nutritional Status and Associated Factors in Non-dialysis Inpatients With Chronic Kidney Disease: a Single-center, Mixed-methods Study.

作者信息

An Nguyen M, Linh Ha D, Long Vo H, Van Doan T, Duc Nguyen V

机构信息

Department of Surgical Nursing, Hanoi Medical College, Hanoi 100000, Vietnam.

Department of Urology, Saint Paul General Hospital, Hanoi 100000, Vietnam.

出版信息

Acta Inform Med. 2024;32(3-4):190-195. doi: 10.5455/aim.2024.32.190-195.

Abstract

BACKGROUND

Malnutrition is a prevalent and critical complication in chronic kidney disease (CKD) patients, adversely affecting clinical outcomes.

OBJECTIVE

This study aimed to assess the prevalence, associated factors, and implications of malnutrition in CKD patients, focusing on the role of nutritional interventions and family support.

METHODS

A cross-sectional study was conducted among CKD patients, utilizing the Subjective Global Assessment (SGA) method to evaluate nutritional status. Additional parameters included body mass index (BMI), serum albumin levels, and self-reported information on nutritional counseling and family support. Logistic regression analysis identified risk factors for malnutrition.

RESULTS

Malnutrition was identified in 76.1% of patients, with a higher prevalence among those aged ≥60 years and those with a disease duration ≥2 years. Elderly patients exhibited a 3.29-fold higher risk of malnutrition, while prolonged disease duration was associated with a 3.68-fold increased risk (both p < 0.05). BMI indicated chronic energy deficiency in 34.0% of patients, highlighting the utility of multi-parameter nutritional assessments. Only 23.2% of patients received nutrition-related information from healthcare professionals, and 81.2% relied on family support, which played a complex yet significant role in dietary adherence.

CONCLUSION

Malnutrition remains a pervasive issue among CKD patients, driven by aging, prolonged disease duration, and limited access to structured nutritional counseling. Comprehensive strategies incorporating early assessment, individualized nutritional interventions, and family engagement are essential to mitigate malnutrition and improve outcomes. Future research should focus on longitudinal, multi-center studies to refine and scale effective nutritional care models for CKD populations.

摘要

背景

营养不良是慢性肾脏病(CKD)患者中普遍存在且严重的并发症,对临床结局产生不利影响。

目的

本研究旨在评估CKD患者营养不良的患病率、相关因素及其影响,重点关注营养干预和家庭支持的作用。

方法

对CKD患者进行横断面研究,采用主观全面评定法(SGA)评估营养状况。其他参数包括体重指数(BMI)、血清白蛋白水平以及关于营养咨询和家庭支持的自我报告信息。逻辑回归分析确定营养不良的危险因素。

结果

76.1%的患者被确定存在营养不良,≥60岁患者和病程≥2年患者的患病率更高。老年患者营养不良风险高3.29倍,而病程延长与风险增加3.68倍相关(均p<0.05)。BMI显示34.0%的患者存在慢性能量缺乏,凸显了多参数营养评估的实用性。只有23.2%的患者从医护人员处获得营养相关信息,81.2%的患者依赖家庭支持,家庭支持在饮食依从性方面发挥了复杂但重要的作用。

结论

营养不良在CKD患者中仍然是一个普遍问题,由衰老、病程延长以及获得结构化营养咨询的机会有限所致。纳入早期评估、个体化营养干预和家庭参与的综合策略对于减轻营养不良和改善结局至关重要。未来研究应聚焦于纵向、多中心研究,以完善和推广针对CKD人群的有效营养护理模式。

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本文引用的文献

1
The global burden of chronic kidney disease.慢性肾脏病的全球负担。
Lancet. 2020 Feb 29;395(10225):662-664. doi: 10.1016/S0140-6736(19)32977-0. Epub 2020 Feb 13.
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Dietary interventions for adults with chronic kidney disease.针对成年慢性肾病患者的饮食干预措施。
Cochrane Database Syst Rev. 2017 Apr 23;4(4):CD011998. doi: 10.1002/14651858.CD011998.pub2.

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