慢性肾脏病患者营养状态分析

Assessment of nutritional status in chronic kidney disease patients

目的探讨慢性肾脏病（CKD）患者营养状态的评估方法，以早期发现CKD患者的营养不良。方法选择CKD非透析患者125例，按MDRD公式计算肾小球滤过率（GFR），依GFR高低分为五组，采用实验室检查、SGA评分、生物电阻抗检查方法分别评价各组的营养状况，分析CKD患者营养状况与GFR的相关性。结果根据SGA，5组患者营养不良的发生率为29％，明显高于其他各组（均P〈0．05）；各组生物电阻抗分析检查，下肢的阻抗值在1kHz、50kHz、500kHz均随着GFR降低而呈下降趋势，各组间比较差异有统计学意义（均P〈0．01）；躯干的阻抗值在50kHz、500kHz随着GFR降低而呈下降趋势，各组问比较差异有统计学意义（均P〈0．05）。结论SGA评分、生物电阻抗等均可评估CKD患者的营养状况，以生物电阻抗检查简单、敏感，可早期发现CKD患者的营养不良。

Objective To investigate good nutritional measurements of CKD patients. In order to diagnose malnutrition early in CKD patients. Methods Clinical data of 125 CKD patients have been collected. The glomerular filtration rate（GFR） was estimated from the modification of diet in renal disease（MDRD）. According to the results of GFR,all CKD patients were divided into five groups. The levels of biochemical markers were assayed. At the same time, bioelectrical impedance analysis （BIA） were measured. We analyzed the relationship between nutritional parameters and GFR. Results According to SGA,malnutrition rate in fifth CKD stage is 29%. Impedance of leg is significantly correlated to GFR in 1 kHz,50kHz and 500kHz,impedance of truck is also significantly correlated to GFR in 50kHz and 500kHz. The values of impedance reduced with the decreasing of GFR. Conclusion SGA and BIA all can be used to evaluate nutritional status of CKD patients. BIA is a more sensitive method to detect early malnutrition and may be useful in monitoring nutrition changes in CKD patients.