透析间期体重增幅并不能影响患者的营养

Interdialytic weight gain does not influence the nutrition of hemodialysis patients

目的:探讨长期血透患者营养状态与透析间期体重增加(interdialytic weight gain,IDWG)之间的关系,为临床预防长期血透患者的营养不良提供方向。方法:收集本院血液净化中心2010年8月～2011年7月间慢性肾脏疾病终末期维持性血液透析的患者123例,选择6项血清学标志物(肌酐、白蛋白、前白蛋白、血钾、血磷、总胆固醇)及6项客观人体学参数作为评价患者营养状态的指标。采用回顾性研究的方法将所有入选患者按照IDWG%分成3组:A组:IDWG%<3%;B组:3%<IDWG%<5%;C组:IDWG%>5%。取3个时间点:研究前(研究之初)、研究中(第6个月末)和研究后(第12个月末)测量患者的营养指标进行单因素方差分析比较各组间有无统计学意义上的差异并对IDWG%与各营养指标之间的关系进行等级相关分析。结果:研究之初、研究中、研究终末3组患者分别进行各营养指标的比较,单因素方差分析结果没有发现显著统计学意义上的差异(P>0.05)。等级相关性分析结果提示不同的IDWG%与各营养指标无明显统计学意义上的相关性(P>0.05)。结论:IDWG与患者的营养状态没有关系,IDWG%与各营养指标之间也没有明确的统计学意义上的相关关系,控制患者IDWG%在相对较低的水平不会影响患者的长期营养状况。

Objective：To explore the relationship between long term hemodialysis patients’ nutritional status and interdialytic weight gain（IDWG）,in order to provide the guidance for preventing of the patients’ malnutrition.Methods：From 2008 August to 2007 July,123 maintenance hemodialysis patients in the end stage of chronic kidney disease of our hospital were divided into 3 groups according to IDWG%（IDWG / dry weight）.Group A：IDWG% 3%;Group B：3% IDWG% 5%;Group C：IDWG% 5%.Six serologic markers and six human body parameters were selected as nutrition indexes to evaluate the patients nutrition status.A retrospective study was adopted to investigate nutritional indexes at the three time points：before study（in the beginning）,amid study（at the end of the sixth month）,after study（at the end of twelfth month）,and single factor analysis of variance was used to evaluate statistical significance difference among the three groups.At the same time,rank correlation analysis was also used to study the relationship between different IDWG% and all nutritional indexes.Results：Nutritional indexes were compared to each other among the three groups respectively in the beginning,in the middle and at the end of study;Single factor analysis of variance revealed no statistically significant differences（P 0.05）.Correlation analysis revealed no statistically significant correlation between different IDWG% and each nutritional index（P 0.05）.Conclusion：There was no relationship between IDWG% and the patients’ nutritional status,and no definite statistically significant correlation between IDWG and each nutritional index.The results suggest that relative low level IDWG% do not affect the patients’ long term nutritional status.