慢性肾病病人营养状况与肾功能的关系分析

Relationship Between Mutrition Status and Renal Function in CKD Patients

目的探讨慢性肾病病人营养状况与肾功能的关系。方法对100例住院肾病病人以简化MDRD公式估算肾小球滤过率(GFR),以GFR<60ml/(min.1.73m2)定义慢性肾功能不全,与GFR>60ml/(min.1.73m2)肾功能基本正常者比较身高、体重、血生化和血常规等,并进行分析。结果肾功能不全组病人体重分布与肾功能正常组比较有显著差异;红细胞、血红蛋白、总淋巴细胞计数水平、胆固醇(P<0.01)、体质量指数(P<0.05)显著降低;血肌酐、尿素氮、尿酸、血磷水平显著升高(P<0.01);血肌酐与红细胞、血红蛋白、体质量指数水平间呈负相关,GFR与红细胞、血红蛋白、体质量指数呈正相关。结论肾功能减退与能量-蛋白质营养不良、贫血、高血磷、高尿酸、低胆固醇等营养障碍表现有关,采取合理饮食有可能保护残存肾功能、干预慢性肾病的进展。

Objective To study the relationship between nutrition status and renal function in CKD patients. Methods The glomer- ular filtration rate（GFR） was estimated with the simplified Modification of Diet in Renal Disease study（MDRD） equation, and GER 〈 60ml/min ·1.73m^2） was considered as renal dysfunction. One hundred CKD inpatients were divided into renal dysfunction group （n = 54） and control group with normal renal function （n = 46）. Body weight, height and the outcomes of blood bioehemicals were compared between the two groups. Results Body weight distribution in renal dysfunction group had marked difference compared with the control group. The levels of RBC, Hb,TLC, cholesterol（ P 〈 0.01 ） and BMI （ P 〈 0. 05 ） were significantly decreased, and the levels of SCr, BUN, UA and serum phosphorus were significantly increased in renal dysfunction group. There was negative linear corelationship between SCr content and WBC,Hb or BMI, while GFR was just the opposite result. Conclusion Renal function deterioration may be concerned with protein -energy malnutrition, anemia, hyperphosphatemia, high serum urea acid and low cholesterol in CKD patients.