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接受持续性非卧床腹膜透析的儿童的营养状况

Nutritional status of children undergoing continuous ambulatory peritoneal dialysis.

作者信息

Salusky I B, Fine R N, Nelson P, Blumenkrantz M J, Kopple J D

出版信息

Am J Clin Nutr. 1983 Oct;38(4):599-611. doi: 10.1093/ajcn/38.4.599.

Abstract

Nutritional status was assessed in 24 clinically stable children, aged 9.68 +/- 4.31 (SD) yr, who underwent CAPD for 6.6 +/- 4.4 months. Energy intake tended to be more suppressed than protein intake. Several nutritional parameters were more abnormal in children less than 10 yr old as compared to children 10 yr of age or older. In comparison to normals of the same chronological age and sex, both groups of patients displayed reduced height, weight, midarm, and midarm muscle circumference, and, in the younger children, triceps skinfold; height retardation was particularly severe. Compared to height/age, anthropometry was not reduced in older children while triceps skinfold and midarm circumference were decreased in children younger than 10 yr. In both groups, serum total protein, albumin, transferrin, and many plasma amino acids were decreased, and serum triglycerides and cholesterol were elevated. Serum total protein decreased during treatment with continuous ambulatory peritoneal dialysis. These observations suggest decreased stature and poor nutritional status in children undergoing continuous ambulatory peritoneal dialysis. Low protein and energy intake and dialysate protein losses may contribute to these abnormalities.

摘要

对24名临床状况稳定、年龄为9.68±4.31(标准差)岁、接受持续性非卧床腹膜透析6.6±4.4个月的儿童进行了营养状况评估。能量摄入往往比蛋白质摄入受到更明显的抑制。与10岁及以上的儿童相比,10岁以下儿童的几个营养参数更为异常。与同年龄、同性别的正常儿童相比,两组患者的身高、体重、上臂围和上臂肌肉围均降低,且年幼儿童的三头肌皮褶厚度也降低;身高发育迟缓尤为严重。与身高/年龄相比,年龄较大儿童的人体测量指标未降低,而10岁以下儿童的三头肌皮褶厚度和上臂围降低。两组患者的血清总蛋白、白蛋白、转铁蛋白和许多血浆氨基酸均降低,血清甘油三酯和胆固醇升高。在持续性非卧床腹膜透析治疗期间,血清总蛋白降低。这些观察结果表明,接受持续性非卧床腹膜透析的儿童身材矮小且营养状况不佳。低蛋白和能量摄入以及透析液中的蛋白质丢失可能是导致这些异常的原因。

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