肾脏内科住院患者营养风险、营养不足及营养干预状况

Nutritional risks, prevalence of undernutrition, and nutritional interventions among inpatients in departments of nephrology in Guangzhou

目的 调查广州市部分医院肾脏内科住院患者的营养风险、营养不足发生率以及营养干预状况,为指导肾脏病患者营养治疗提供依据.方法 采用营养风险筛查2002（NRS 2002）工具,对广州市部分医院378例肾脏内科住院患者进行营养风险筛查,以NRS 2002评分≥3分为有营养风险,体重指数（BMI）＜18.5 kg/m^2（或白蛋白＜30 g/L）为营养不足,并调查营养干预情况,分析营养风险与营养干预之间的关系.结果 378例肾脏内科患者营养不足和营养风险的发生率分别为21.7%和41.3%,其中慢性肾功能不全患者营养不足和营养风险发生率最高,分别为24.3%和60.7%;糖尿病肾病患者的营养风险发生率为42.3%.378例患者中,102例（27.0%）接受了营养支持,其中有营养风险患者的营养支持率为50.0%（78/156）,无营养风险患者的营养支持率为10.8%（24/222）.结论 广州部分医院肾脏内科住院患者中营养风险或营养不足的发生率较高,营养干预存在不合理性,应引起关注并规范营养干预指南以改善此状况.

Objective To investigate the nutritional risks, prevalence of undernutrition, and nutritional interventions among inpatients in departments of nephrology in some hospitals in Guangzhou, with an attempt to provide evidences for the nutritional support of patients with kidney diseases. Methods Totally 378 adult patients in departments of nephrology in Guangzhou were enrolled in this study by fix-point consecutive sampling. Nutritional Risk Screening 2002 （NRS 2002） was applied for nutritional risk assessment. Nutrition risk was defined by NRS score ≥3 and undernutrition by BMI 〈 18.5 kg/m^2 or serum albumin 〈 30 g/L. Nutritional interventions were also evaluated in all patients. The relationship between nutritional risk and nutritional support was analyzed. Results The overall prevalence of undernutrition was 21.7% and the nutritional risk was 41.3%. They were especially high among patients with chronic kidney dysfunction （24. 3% and 60. 7% , respectively）. The nutritional risk was 42. 3% in patients accompanied with diabetes （P〉0. 05）. Of these 378 patients, 102 （27.0%） received nutritional interventions, in which the nutritional support rate was 50. 0% （78/156） for patients with nutritional risks and 10. 8% （24/222） for those without nutritional risks. Conclusions The nutritional risks and prevalence of undernutrition are high among inpatients in the departments of nephrology in hospitals in Guangzhou. Proper application of nutritional interventions remains a concern. Evidence-based guidelines are required to improve this situation.