低脂低蛋白膳食在老年慢性肾脏病患者中的临床应用

Clinical application of low fat and low protein diet in elderly patient with chronic kidney disease

目的探讨低脂低蛋白膳食在老年慢性肾脏病患者中的应用效果。方法选取本院老年慢性肾脏病患者106例．应用SGA对患者进行营养评价，然后根据患者的依从性分为两组，观察组给予蛋白质0．6～0．8g/（ks·d）、脂肪≤40g／d，对照组给予蛋白质1．0s／（kg·d）、脂肪占总热能的18％～20％，营养干预3个月后，观察两组的营养不良发生率、空腹血糖（FBG）、血浆白蛋白（ALB）、前白蛋白（PA）、血红蛋白（Hb）、胆固醇（TC）、三酰甘油（TG）、尿素氮（BUN）、肌酐（SCr）、估算肾小球滤过率（c—aGFR）。结果两组治疗后的营养不良发生率比较差异无统计学意义（P〉0．05）。两组的FBG、ALB、PA、HB、TC及TG治疗前后及组间比较，差异无统计学意义（P〉0．05）。观察组治疗后的BUN、SCr低于治疗前及对照组，c—aGFR高于治疗前，差异有统计学意义（P〈0．05）。结论低脂低蛋白膳食是老年慢性肾脏病综合治疗中的基础之一。

Objective To discuss application effect of low fat and low protein diet in elderly patient with chronic kid- ney disease. Methods 106 cases of elderly patients with chronic kidney disease in our hospital were seleeted.SGA was used to assess the nutritional status of patients and the patients were divided into two groups according to the compli- ance.Observation group was given a low protein from 0.6 to 0.8 g/（kg· d）,fat ≤40 g/d,control group was given 1.0 g/（kg＂ d）protein and fat （18%-20% of the total thermal energy）.After 3 months of nutrition intervention,the incidence rate of malnutrition,fasting blood glucose （FBG）,serum albumin （ALB）,prealbumin （PA）,hemoglobin （Hh）,cholesterol （TC）,triglyc- eride（TG）,bloodureanitrogen（BUN）,serum creatinine（SCr）,estimated glomerular filtration rate （c-aGFR） in two groups was compared respectively. Results The incidence of malnutrition in two groups was compared,with no statistical difference （P〉0.05）.FBG,ALB,PA,HB,TC and TG in two groups before and after treatment was compared respeetively,FBG,ALB, PA,HB,TC and TG in two groups was compared respectively,with no statistical difference（P〉0.05）.Afler treatment,BUN, SCr in observation group was lower than that in control group and before treatment respeetively,c-aGFR was higher than before treatment,with statistical difference （P〈0.05）. Conclusion Low fat and low protein diet is one of the basic treatments in comprehensive treatment of elderly patients with chronic kidney disease.