Hawary肾脏中心和班加西医疗中心肾内科终末期肾病维持性血液透析患者营养状况的研究

IF 2.3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Safia S. Elramli
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引用次数: 0

摘要

背景:营养不良在血液透析患者中很常见,它是发病率和死亡率的一个强有力的预测因子。因此,充足的营养对这类患者非常重要。血液透析患者的营养管理是影响预后、改善总体预后和生活质量的重要因素。目的:本研究主要旨在确定血液透析患者的营养状况和营养不良发生率,探讨营养指标、身体质量指数(BMI)等人体测量参数和常规实验室参数与SGA的关系。患者与方法:对2019年12月至2020年1月在班加西医疗中心Hawari Nephro中心和Nephro单元的HD患者进行横断面研究。这项研究共招募了155名HD患者,并评估了他们的营养状况,包括18岁及以上的男性和女性,并定期进行血液透析。结果测量:测量包括问卷调查,以获取社会人口统计学特征、患者病史和血液透析持续时间等信息。测量了人体测量、生化指标。采用7点主观整体评价(7点SGA)评价HD患者的营养状况。在研究期间,从研究患者的医疗档案中获得生化测试。数据分析采用描述性统计。采用卡方检验对研究资料进行检验。结果:数据显示,58%的HDP营养良好,其余39%,3%为轻度至重度营养不良。在男女营养不良发生率方面,男性组营养不良发生率高于女性组。SGA评分结果与患者透析后BMI、白蛋白有显著相关,而性别、收入、教育程度、合并症等人口统计学特征、HD病程、频次等临床变量以及电解质、磷、血红蛋白、胆固醇等生化指标与SGA评分呈负相关。此外,研究结果显示,营养摄入、膳食方式与HD患者合并SGA之间的相关性不显著。结论:观察透析患者的营养状况是维持透析患者健康状态的必要条件。应采取各种措施避免出现尿毒症状态下血液透析的并发症,包括厌食、恶心、呕吐导致营养不良、体液和电解质失衡导致容量超载、高钾血症、代谢性酸中毒、高磷血症,以及与激素或全身功能异常相关的高血压、贫血、高脂血症、骨病等。及时诊断蛋白质能量浪费(PEW)对于早期开始营养干预和治疗是很重要的。此外,应制定教育计划,以调节营养摄入,识别患者的困难并提供实际帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study of the nutritionalstatus of end-stage renal disease patients onmaintenance hemodialysis in Hawary Kidney center and nephrology unit atBenghazi Medical Center
Background: Malnutrition, which is a powerful predictor of morbidity and mortality, is common in patients undergoing hemodialysis. There-fore, adequate nutrition is very important for such patients. Nutritional management in hemodialysis patients is a very important factor for prognosis , a better overall outcome and quality of life. Objectives: The current study mainly aimed to determine the nutritional status and prevalence of malnutrition and to investigate the relationship between nutritional markers, anthropometric parameters such as body mass index (BMI), and routine laboratory parameters with SGA in patients undergoing hemodialysis. Patients and Methods: A cross-sectional study was carried out on HD patients in Hawari Nephro Center and Nephro Unit of Beng-hazi Medical Center from December 2019 to January 2020. A total of 155 HD patients were recruited for this study and assessed for nutritional status include both Male and females aged 18 years and over with regular hemodialysis. Outcome measures: Measurements included questionnaire that elicited information on social demographic characteristics, Patient’s medical history , and duration of hemodialysis. Anthropometry, biochemical parameters were measured. Seven-Point Subjective Global Assessment (7-point SGA) was used to assess the nutritional state of HD patients. Biochemical tests were obtained during the study period from medical files of the studied patients. Data were analyzed using descriptive statistics. The Chi-Square test was applied to examine the study data. Results: Data shows that 58% of HDP were well-nourished while the remaining 39%, 3%had mild-to-severe malnutrition. Regarding the prevalence of malnutrition in both gender, males group was mor preva-lent of malnourished than female group. SGA score results indicated some significant correlations with patient’s post dialysis BMI and albumin ,however, there was a negative correlation between demographic characteristics as gender, income, education level, comorbid disease , clinical variable such as duration and frequency of HD and some biochemical tests as electrolytes, phosphorous ,hemoglobin, cholesterol with SGA scores. In addition, results show that insignificant correlation between nutrients intake, meals pattern of HD patients with SGA. Conclusions: Observations of nutritional status are necessary to maintain the health status of dialysis patients. Every strategy should be used to avoid complications of hemodialysis manifested in uremic state including anorexia, nausea, vomiting leading to malnutrition, fluid and electrolyte imbalance leading to volume overload, hyperkalemia, metabolic acidosis, and hyperphosphatemia, as well as abnormalities related to hormonal or systemic dysfunction such as hypertension, anemia, hyperlipidemia, and bone disease, Timely diagnosis of protein-energy-wasting (PEW) is important for early initiation of nutritional intervention and treatment. In addition, education plans should be prepared to mediate the nutrient intakes and identify the patient's difficulties and provide practical help.
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来源期刊
Clinical Medicine Insights. Cardiology
Clinical Medicine Insights. Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.20
自引率
3.30%
发文量
16
审稿时长
8 weeks
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