{"title":"评估透析和非透析日接受血液透析治疗的肾衰竭患者的营养摄入情况。","authors":"Haalah Shaaker, Andrew Davenport","doi":"10.1053/j.jrn.2024.07.009","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction/aims/objective: </strong>Inadequate nutritional intake in haemodialysis (HD) patients increases the risk of muscle wasting, nutrient deficiencies, leading to an increased risk of additional morbidity and mortality. We aimed to assess nutritional intake on the dialysis day and nondialysis day (NDD) of patients established on HD.</p><p><strong>Methods: </strong>We employed a 2-day dietary record, one on the day of dialysis and one on the NDD, and then determined nutritional intake using the Nutritics software. Muscle strength was assessed by hand grip strength, and the body composition was determined using multifrequency bioelectrical impedance recorded postdialysis.</p><p><strong>Results: </strong>We recruited 51 established HD patients dialysing between May 2022 and July 2022, of mean age 60 ± 15 years, 52.9% male, and 51% diabetic. Only 25% achieved the calorie and protein intake recommended by Kidney Disease Outcomes Quality Initiative. Most patients had inadequate consumption of fiber (96%), calcium (86%), iron (80%), zinc (82%), selenium (92%), folate (82%), vitamin A (88%), and (100%) vitamin D. On the other hand, the great majority followed the restriction guidelines for potassium (96%), phosphorus (86%), and sodium (84%), respectively. However, consumption was greater for potassium (P = .007), phosphorus (P = .015), and zinc (P = .032) on NDDs versus dialysis days, but there was no difference in protein or calorie intake between days.</p><p><strong>Conclusion: </strong>Our results suggest that many of our HD patients do not achieve the recommended nutritional targets. Patient compliance with restricting sodium, potassium, and phosphate limits protein and calorie intake. HD patients are at increased risk of sarcopenia, so failure to achieve dietary protein intake will further increase this risk.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of Nutritional Intake in Patients With Kidney Failure Treated by Haemodialysis on Dialysis and Non-dialysis Days.\",\"authors\":\"Haalah Shaaker, Andrew Davenport\",\"doi\":\"10.1053/j.jrn.2024.07.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction/aims/objective: </strong>Inadequate nutritional intake in haemodialysis (HD) patients increases the risk of muscle wasting, nutrient deficiencies, leading to an increased risk of additional morbidity and mortality. We aimed to assess nutritional intake on the dialysis day and nondialysis day (NDD) of patients established on HD.</p><p><strong>Methods: </strong>We employed a 2-day dietary record, one on the day of dialysis and one on the NDD, and then determined nutritional intake using the Nutritics software. Muscle strength was assessed by hand grip strength, and the body composition was determined using multifrequency bioelectrical impedance recorded postdialysis.</p><p><strong>Results: </strong>We recruited 51 established HD patients dialysing between May 2022 and July 2022, of mean age 60 ± 15 years, 52.9% male, and 51% diabetic. Only 25% achieved the calorie and protein intake recommended by Kidney Disease Outcomes Quality Initiative. Most patients had inadequate consumption of fiber (96%), calcium (86%), iron (80%), zinc (82%), selenium (92%), folate (82%), vitamin A (88%), and (100%) vitamin D. On the other hand, the great majority followed the restriction guidelines for potassium (96%), phosphorus (86%), and sodium (84%), respectively. However, consumption was greater for potassium (P = .007), phosphorus (P = .015), and zinc (P = .032) on NDDs versus dialysis days, but there was no difference in protein or calorie intake between days.</p><p><strong>Conclusion: </strong>Our results suggest that many of our HD patients do not achieve the recommended nutritional targets. Patient compliance with restricting sodium, potassium, and phosphate limits protein and calorie intake. HD patients are at increased risk of sarcopenia, so failure to achieve dietary protein intake will further increase this risk.</p>\",\"PeriodicalId\":50066,\"journal\":{\"name\":\"Journal of Renal Nutrition\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Renal Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.jrn.2024.07.009\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Renal Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jrn.2024.07.009","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
引言/目的/目标:血液透析(HD)患者营养摄入不足会增加肌肉萎缩和营养缺乏的风险,从而导致发病率和死亡率上升。我们旨在评估血液透析患者在透析日和非透析日的营养摄入情况:我们采用了两天的饮食记录,透析日和非透析日各一次,然后使用 Nutritics 软件确定营养摄入量。肌肉力量通过手部握力(HGS)进行评估,身体成分通过透析后记录的多频生物电阻抗进行测定:我们招募了 51 名在 2022 年 5 月至 7 月间透析的既往 HD 患者,平均年龄为 60±15 岁,52.9% 为男性,51% 为糖尿病患者。只有 25% 的患者达到了肾脏疾病结果质量倡议(KDOQI)推荐的卡路里和蛋白质摄入量。大多数患者的纤维摄入量不足(96%),钙摄入量不足(86%),铁摄入量不足(80%),锌摄入量不足(82%),硒摄入量不足(92%),叶酸摄入量不足(82%),维生素 A 摄入量不足(88%),维生素 D 摄入量不足(100%)。然而,非透析日与透析日的钾摄入量(P=0.007)、磷摄入量(P=0.015)和锌摄入量(P=0.032)均高于透析日,但蛋白质或卡路里摄入量在透析日之间没有差异:我们的研究结果表明,许多血液透析患者没有达到推荐的营养目标。患者对限制钠、钾和磷酸盐的依从性限制了蛋白质和热量的摄入。血液透析患者患肌肉疏松症的风险较高,因此未能达到饮食蛋白质摄入量将进一步增加这一风险。
Assessment of Nutritional Intake in Patients With Kidney Failure Treated by Haemodialysis on Dialysis and Non-dialysis Days.
Introduction/aims/objective: Inadequate nutritional intake in haemodialysis (HD) patients increases the risk of muscle wasting, nutrient deficiencies, leading to an increased risk of additional morbidity and mortality. We aimed to assess nutritional intake on the dialysis day and nondialysis day (NDD) of patients established on HD.
Methods: We employed a 2-day dietary record, one on the day of dialysis and one on the NDD, and then determined nutritional intake using the Nutritics software. Muscle strength was assessed by hand grip strength, and the body composition was determined using multifrequency bioelectrical impedance recorded postdialysis.
Results: We recruited 51 established HD patients dialysing between May 2022 and July 2022, of mean age 60 ± 15 years, 52.9% male, and 51% diabetic. Only 25% achieved the calorie and protein intake recommended by Kidney Disease Outcomes Quality Initiative. Most patients had inadequate consumption of fiber (96%), calcium (86%), iron (80%), zinc (82%), selenium (92%), folate (82%), vitamin A (88%), and (100%) vitamin D. On the other hand, the great majority followed the restriction guidelines for potassium (96%), phosphorus (86%), and sodium (84%), respectively. However, consumption was greater for potassium (P = .007), phosphorus (P = .015), and zinc (P = .032) on NDDs versus dialysis days, but there was no difference in protein or calorie intake between days.
Conclusion: Our results suggest that many of our HD patients do not achieve the recommended nutritional targets. Patient compliance with restricting sodium, potassium, and phosphate limits protein and calorie intake. HD patients are at increased risk of sarcopenia, so failure to achieve dietary protein intake will further increase this risk.
期刊介绍:
The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.