Leibowitz J, Uribarri J
Department of Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.
Clin Nephrol. 1998 Nov;50(5):315-9.
Since dietary protein is required for replenishment of lean body mass and since dialysis patients may have a significant increase in body fat, it makes sense to express protein intake normalized per lean body mass. However, this may be complicated since the daily protein requirements of man, based on studies done in the past with normal subjects, are usually expressed in grams of protein per kilogram of body weight.
We analyzed our data on urea and creatinine kinetics obtained in the routine clinical care of our peritoneal dialysis patients and calculated lean body mass from creatinine appearance rate. Using this lean body mass, we then reconfigured the patients' body to match the same proportion of lean body mass as in reference young men in which the initial recommendations for normal intake of protein were made.
We believe that this new theoretical body weight obtained by assuming that lean body mass always represents 85% of it may provide a more rational way to normalize daily protein intake.
由于膳食蛋白质是补充瘦体重所必需的，且透析患者的体脂可能会显著增加，因此按瘦体重对蛋白质摄入量进行标准化是合理的。然而，这可能会很复杂，因为根据过去对正常受试者的研究，人类每日蛋白质需求量通常以每千克体重的蛋白质克数来表示。
我们分析了在腹膜透析患者的常规临床护理中获得的尿素和肌酐动力学数据，并根据肌酐出现率计算瘦体重。利用这个瘦体重，我们随后重新构建患者的身体，使其瘦体重比例与参考年轻男性相同，而最初关于蛋白质正常摄入量的建议就是基于这些年轻男性制定的。
我们认为，通过假设瘦体重始终占新理论体重的85%而获得的这种新理论体重，可能为每日蛋白质摄入量的标准化提供一种更合理的方法。
