■由于食欲和睡眠的紊乱密切相关,两者都影响代谢紊乱,预计肾脏特异性口服营养补充剂(RS-ONS)涵盖了患者在HD当天不消耗的能量,可能有助于改善营养状况和身体成分,以及睡眠质量。与此主题相关的信息仍然很少。
■评估使用透析内RS-ONS的效果与在家里关于睡眠质量的RS-ONS,营养状况,HD患者的身体成分。
■成年患者<65岁,HD≥3个月的患者被邀请参加一项开放随机试验研究(ISRCTN33897).患者被随机分配到HD期间提供的透析特异性高蛋白补充剂(透析中口服营养[ION])或在家中(对照),在非HD天(每周三次,两者)12周。主要结果是由匹兹堡睡眠质量指数(PSQI)评分定义的睡眠质量。营养评估包括营养不良炎症评分(MIS),生物电阻抗分析,人体测量学,3天的食物记录,和常规血液化学.
■共有23名患者完成了研究。年龄中位数为35岁(范围24-48岁),42%是女性。在基线,PSQI得分为中位数4(范围2-7),MIS的中位数为6(范围5-8);组间无基线差异.干预后,两组都提高了他们的MIS评分,当我们分析整个队列时也是如此(前与干预后P<0.01)。ION组患者PSQI总评分提高至中位数3(2-5),并评估睡眠持续时间和睡眠障碍(前与干预后P<0.05),与在家服用补充剂的患者相比,具有效果差异的趋势(PSQI评分为0.07,睡眠潜伏期为0.05)。
■口服补充剂改善了整个队列的营养状况,但只有ION提高了PSQI分数。需要更多的研究来探索影响HD患者睡眠与营养状况之间关系的营养策略。
UNASSIGNED: Since disturbances of appetite and sleep are closely related and both affect metabolic disorders, it would be expected that a renal specific oral nutritional supplement (RS-ONS) that covers the energy the patient does not consume on the HD day, could contribute to improve the nutritional status and body composition, as well as sleep quality. There is still scarce information related to this topic.
UNASSIGNED: To evaluate the effect of the use of intra-dialytic RS-ONS vs. RS-ONS at home on sleep quality, nutritional status, and body composition in patients on HD.
UNASSIGNED: Adult patients < 65 years, with ≥3 months on HD were invited to participate in an open randomized pilot
study (ISRCTN 33897). Patients were randomized to a dialysis-specific high-protein supplement provided during the HD session (Intradialytic oral nutrition [ION]) or at home (control), during non-HD days (thrice weekly, for both) 12 weeks. The primary outcome was sleep quality defined by the Pittsburgh Sleep Quality Index (PSQI) score. Nutritional assessment included Malnutrition Inflammation Score (MIS), bioelectrical impedance analysis, anthropometry, 3-day food records, and routine blood chemistries.
UNASSIGNED: A total of 23 patients completed the
study. Age was median 35 (range 24-48 years), 42% were women. At baseline, the PSQI score was median 4 (range 2-7), and MIS showed a median of 6 (range 5-8); there were no baseline differences between groups. After intervention, both groups improved their MIS scores and similarly when we analyzed the whole cohort (pre- vs. post-intervention P < 0.01). Patients in the ION group improved the overall PSQI score to median 3 (2-5), and assessment of sleep duration and sleep disturbances (pre- vs. post-intervention P < 0.05), with a trend toward an effect difference compared to patients consuming the supplement at home (P for treatment-effect across arms 0.07 for PSQI score and 0.05 for sleep latency).
UNASSIGNED: Oral supplementation improved nutritional status in the whole cohort, but only ION improved the PSQI score. More studies are needed to explore the nutritional strategies that influence the relationship between sleep and nutritional status in HD patients.