在外体置换治疗功能衰竭的婴儿中提供营养
Samantha L Krieger1, Melissa S Zhou1, Laura Popovich2
1Division of Nephrology, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
Pediatric nephrology (Berlin, Germany)
|March 1, 2026
概括
接受脏替代疗法 (KRT) 的婴儿经历了尽管有营养支持的生长缺陷. 在KRT早期更高的蛋白质和卡路里摄入量可能对这些脆弱的婴儿的最佳生长至关重要.
科学领域:
- 儿科脏病学 儿科脏病学
- 新生儿重症监护中心
- 临床营养学 临床营养学
背景情况:
- 患有功能衰竭的婴儿需要置换疗法 (KRT) 需要精确的液体和营养管理来促进生长.
- 连续或长期间歇性KRT (CKRT/PIKRT) 促进早期营养,但可能导致蛋白质损失.
- 目前的指导方针建议KRT期间每天蛋白质≥3-3.5g/kg,但最佳摄入量仍在研究中.
研究的目的:
- 评估婴儿在生命的前三个月内开始KRT的营养处方和生长结果.
- 评估当前在高风险人群中营养支持策略的充分性.
主要方法:
- 衰竭的婴儿进行体外KRT的回顾性审查.
- 数据收集包括人口统计,透析参数,营养摄入量,人体测量和实验室值.
- 分析范围从出生到8周,再到出院.
主要成果:
- 17名婴儿 (71%的女性) 在3天的中位年龄和2110克的体重开始KRT.
- 处方蛋白质从第1周的2.7g/kg/day增加到第6周的4g/kg/day;卡路里从95升至136kcal/kg/day.
- 体重,长度和头周长的中位数z-score从出生到8周的时间下降,这表明追赶增长有限.
结论:
- 尽管有营养优化努力,但接受KRT的婴儿表现出不理想的增长.
- 早期提供更高的蛋白质 (≥4 g/kg/day) 和卡路里 (≥130 kcal/kg/day) 可能是必要的,以防止累积增长缺陷.
- 对KRT婴儿量身定制的营养策略进行进一步研究是有必要的.
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