开始腹腔透析的患者的营养状况:计划和计划外透析启动之间的比较
Maryanne Zilli Canedo Silva1, Carla Maria Avesani2, Barbara Perez Vogt3
1Internal Medicine Department, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil.
概括
未计划的腹腔透析 (PD) 启动与较差的营养状况和较高的疾病死亡率有关. 计划的PD启动对于更好的患者结果和营养健康至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床营养学 临床营养学
- 内部医学 内部医学
背景情况:
- 低于最佳的透析启动,特别是计划外腹膜透析 (PD),是与患者发病率和死亡率增加相关的重大问题.
- 计划和非计划的PD启动之间的营养状况差异以前没有被调查过.
研究的目的:
- 评估和比较通过非计划与计划模式启动腹腔透析 (PD) 的患者的营养状况.
主要方法:
- 一项观察性研究涉及47名开始PD的成年患者.
- 在PD开始后30天内评估营养状况,使用人体测量,生物电阻分析,食欲,手握强度,实验室标记和营养不良-炎症评分.
- 患者被分为非计划型 (导管植入后72小时内进行透析) 和计划型 (透析前随访>90天) 组.
主要成果:
- 非计划的PD启动与糖尿病的更高患病率,血糖,尿素和糖化血红蛋白的升高有关.
- 患有非计划性PD的患者表现出较低的血红蛋白和白蛋白水平,小腿周长缩小,步行速度减慢.
- 尽管非计划组的蛋白质摄入量和营养不良-炎症得分较高,但身体活动和食欲水平并没有显著差异.
结论:
- 经过非计划性PD启动的患者与计划性启动的患者相比,表现不佳的临床和营养标志物.
- 这表明,缺乏足够的透析前随访会对患者的临床和营养状况产生负面影响.
- 强调需要透析的患者保守管理和计划启动的重要性.
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