■为了调查维持性血液透析(MHD)患者的饮食营养素摄入量,确定影响因素,探讨膳食营养素摄入与营养和疾病控制指标的相关性。
■这是一项多中心横断面研究。采用三天膳食记录法进行膳食调查,并利用自行设计的饮食管理软件计算每日膳食营养素的摄入量。营养状况和疾病控制指标采用主观整体评估,握力,验血指标,和透析充分性。
■本研究共纳入382例MHD患者。其中,225例(58.9%)和233例(61.0%)患者的蛋白质和能量摄入未达到国家肾脏基金会的肾脏疾病结局质量倡议《慢性肾脏疾病营养临床实践指南》(2020年更新)中概述的建议。这些患者的平均蛋白质和能量摄入分别为0.99±0.32g/kg/d和29.06±7.79kcal/kg/d,分别。多元线性回归分析显示,共病-糖尿病对正常每日能量摄入(nDEI=DEI/理想体重)(B=-2.880,p=0.001)和正常每日蛋白质摄入(nDPI=DPI/理想体重)(B=-0.109,p=0.001)有负面影响。Pearson相关分析显示,膳食DPI(r=-0.109,p<0.05),DEI(r=-0.226,p<0.05)和磷(r=-0.195,p<0.001)的摄取量与Kt/V有统计学相关性;膳食nDPI(r=0.101,p<0.05)和钠(r=-0.144,p<0.001)的摄取量与血清尿素氮有统计学相关性;膳食DPI(r=0.200,p<0.001),DEI(r=0.241,p<0.001),钾(r=0.129,p<0.05),磷(r=0.199,p<0.001),纤维(r=0.157,p<0.001)摄入量与血肌酐有统计学相关性;膳食磷(r=0.117,p<0.05)和纤维(r=0.142,p<0.001)摄入量与血磷有统计学相关性;膳食nDPI(r=0.125,p<0.05),DPI(r=0.135,p<0.05),nDEI(r=0.116,p<0.05),DEI(r=0.125,p<0.05),钾(r=0.148,p<0.001),和磷(r=0.156,p<0.001)的摄入量与主观全局评估得分有统计学相关性;饮食nDPI(r=0.215,p<0.001),DPI(r=0.341,p<0.001),nDEI(r=0.142,p<0.05),DEI(r=0.241,p<0.001),钾(r=0.166,p<0.05),磷(r=0.258,p<0.001),和纤维(r=0.252,p<0.001)的摄入量与男性的握力具有统计学相关性;膳食纤维(r=0.190,p<0.05)的摄入量与女性的握力具有统计学相关性。
■MHD患者的膳食营养素摄入量需要改善。MHD患者的膳食营养摄入不足可能对他们的血液测试指标和总体营养状况产生不利影响。至关重要的是解决和优化该患者人群中营养的饮食摄入,以增强他们的健康结果和福祉。
UNASSIGNED: To investigate the dietary nutrient intake of Maintenance hemodialysis (MHD) patients, identify influencing factors, and explore the correlation between dietary nutrient intake and nutritional and disease control indicators.
UNASSIGNED: This was a multicenter cross-sectional study. A dietary survey was conducted using a three-day dietary record method, and a self-designed diet management software was utilized to calculate the daily intake of dietary nutrients. The nutritional status and disease control indicators were assessed using subjective global assessment, handgrip strength, blood test indexes, and dialysis adequacy.
UNASSIGNED: A total of 382 MHD patients were included in this study. Among them, 225 (58.9%) and 233 (61.0%) patients\' protein and energy intake did not meet the recommendations outlined in the National Kidney Foundation\'s Kidney Disease Outcomes Quality Initiative Clinical Practice Guideline for Nutrition in Chronic Kidney Disease (2020 update). The average protein and energy intake for these patients were 0.99 ± 0.32 g/kg/d and 29.06 ± 7.79 kcal/kg/d, respectively. Multiple linear regression analysis showed that comorbidity-diabetes had a negative influence on normalized daily energy intake (nDEI = DEI / ideal body weight) (B = -2.880, p = 0.001) and normalized daily protein intake (nDPI = DPI / ideal body weight) (B = -0.109, p = 0.001). Pearson correlation analysis revealed that dietary DPI (r = -0.109, p < 0.05), DEI (r = -0.226, p < 0.05) and phosphorus (r = -0.195, p < 0.001) intake were statistically correlated to Kt/V; dietary nDPI (r = 0.101, p < 0.05) and sodium (r = -0.144, p < 0.001) intake were statistically correlated to serum urea nitrogen; dietary DPI (r = 0.200, p < 0.001), DEI (r = 0.241, p < 0.001), potassium (r = 0.129, p < 0.05), phosphorus (r = 0.199, p < 0.001), and fiber (r = 0.157, p < 0.001) intake were statistically correlated to serum creatinine; dietary phosphorus (r = 0.117, p < 0.05) and fiber (r = 0.142, p < 0.001) intake were statistically correlated to serum phosphorus; dietary nDPI (r = 0.125, p < 0.05), DPI (r = 0.135, p < 0.05), nDEI (r = 0.116, p < 0.05), DEI (r = 0.125, p < 0.05), potassium (r = 0.148, p < 0.001), and phosphorus (r = 0.156, p < 0.001) intake were statistically correlated to subjective global assessment scores; dietary nDPI (r = 0.215, p < 0.001), DPI (r = 0.341, p < 0.001), nDEI (r = 0.142, p < 0.05), DEI (r = 0.241, p < 0.001), potassium (r = 0.166, p < 0.05), phosphorus (r = 0.258, p < 0.001), and fiber (r = 0.252, p < 0.001) intake were statistically correlated to handgrip strength in males; dietary fiber (r = 0.190, p < 0.05) intake was statistically correlated to handgrip strength in females.
UNASSIGNED: The dietary nutrient intake of MHD patients need improvement. Inadequate dietary nutrient intake among MHD patients could have a detrimental effect on their blood test indexes and overall nutritional status. It is crucial to address and optimize the dietary intake of nutrients in this patient population to enhance their health outcomes and well-being.