饮食中草酸的摄入影响肾衰竭患者血浆草酸浓度。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-22 DOI:10.1016/j.clnesp.2025.03.030

Wesley J. Visser , Gideon Post Hospers , Anneke M.E. van Egmond , Mirjam Laging , Jeroen G.H.P. Verhoeven , Sara J. Baart , Chris R.B. Ramakers , Ingrid R.A.M. Mertens zur Borg , Michel J. Vos , Ido P. Kema , Dennis A. Hesselink , Jacqueline van de Wetering , Marlies E.J. Reinders , Ewout J. Hoorn , David Severs , Joke I. Roodnat

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引用次数: 0

摘要

背景与目的：高草酸尿可引起肾结石、肾功能下降，最终导致肾（移植）衰竭。高血浆浓度可导致全身性草酸中毒。当肾功能恶化时，血浆草酸浓度升高。除肾功能外，饮食摄入对草酸血浆浓度的影响尚不清楚。方法：采用自行编制的食物频次问卷，测定平均及最后24 h日粮草酸摄入量。根据频率和份量，FFQ计算每日平均草酸摄入量和过去24小时的摄入量。肾移植前立即测定血浆草酸浓度。结果：纳入418例患者，中位年龄62岁（51-69岁），60%男性，66%透析，中位透析时间13个月（0-27）。平均草酸摄入量为199毫克/天（范围4-1599毫克）；移植前最后24小时为138 mg/天（范围0-3906）。血浆草酸浓度中位数为32.2 μmol/L(4.6 ~ 243.2)， 98.3%的患者高于正常上值（7.2 μmol/L）。多变量线性回归分析显示血浆草酸浓度与平均和最后24小时摄入量、体重指数、透析年份、年龄、残余利尿以及透析与透析前状态相关。这些关联具有临床意义，最低和最高摄入量转化为血浆草酸变化分别为23.5和49.5 μmol/L。结论：几乎所有肾功能衰竭患者血浆草酸浓度均高于正常上限，饮食中草酸的摄入对血浆草酸浓度有影响。

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Dietary intake of oxalic acid affects plasma oxalic acid concentration in patients with kidney failure

Background & aims

Hyperoxaluria may cause kidney stones, kidney function decline and eventually kidney (transplant) failure. High plasma concentrations may lead to systemic oxalosis. Plasma oxalic acid concentrations increase when kidney function deteriorates. Apart from kidney function, the contribution of dietary intake on the oxalic acid plasma concentration is unknown.

Methods

Average and last 24 h dietary oxalic acid intake was assessed by a self-developed food frequency questionnaire. Based on frequency and portion size, the FFQ calculates daily average oxalic acid intake and last 24 h intake. Plasma oxalic acid concentration was determined immediately before kidney transplantation.

Results

We included 418 patients, median age 62 years (51–69), 60 % male, 66 % on dialysis, median dialysis vintage 13 months (0–27). Average oxalic acid intake was 199 mg/day (range 4–1599); in the last 24 h before transplantation it was 138 mg/day (range 0–3906). Median plasma oxalic acid concentration was 32.2 μmol/L (range 4.6–243.2), while 98.3 % of patients had concentrations above the upper normal value (7.2 μmol/L). Multivariable linear regression analysis showed that plasma oxalic acid concentration was associated with average and last 24-h intake, body mass index, dialysis vintage, age, residual diuresis, and dialysis versus pre-dialysis status. The associations found are clinically relevant, with the lowest and highest intakes translating to plasma oxalic acid changes of 23.5 and 49.5 μmol/L, respectively.

Conclusion

In nearly all patients with kidney failure plasma oxalic acid concentration was above the upper normal concentration and dietary oxalic acid intake affects plasma oxalic acid concentration.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.