蛋白尿增加肾病住院患者的营养风险

Proteinuria increases nutritional risk of hospitalized kidney disease patients

目的调查肾病住院患者的营养风险以及相关的危险因素。方法选取2017年1月～2017年5月在北京大学人民医院肾内科住院的患者120例,使用营养风险筛查表(nutritional risk screening 2002,NRS2002)评估其营养风险,应用Logistic回归分析患者发生营养风险的危险因素。结果120例患者中存在营养风险的占60.8%。有营养风险的患者体质量指数(body mass index,BMI)更低(t=2.542,P=0.012)、24h尿蛋白更高(Z=-2.406,P=0.016)、血白蛋白更低(t=6.155,P<0.001)。血白蛋白(OR=0.643,95%CI 0.521～0.794,P<0.001)和24h尿蛋白定量(OR=0.264,95%CI 0.119～0.588,P=0.001)为发生营养风险的危险因素,且两者存在交互作用。结论北京大学人民医院肾内科住院患者营养风险发生率较高,蛋白尿是营养风险发生的危险因素,需要临床提高警惕、早期干预。

Objective To evaluate the nutritional risk and its related risk factors in hospitalized kidney disease patients.Methods A total of 120 hospitalized patients in the nephrology ward were recruited.Their nutritional risks were evaluated using nutritional risk screening 2002(NRS2002).Logistic regression model was used to analyze the risk factors.Results The prevalence of patients at nutritional risk in our nephrology ward was 60.8%.Compared with those without nutritional risk,patients with nutritional risk had lower BMI(t=2.542,P=0.012),lower serum albumin(t=6.155,P<0.001)and higher urina ry protein(Z=-2.406,P=0.016).Serum albumin(OR=0.643,95%CI 0.521~0.794,P<0.001)and 24-hour urinary protein(OR=0.264,95%CI 0.119~0.588,P=0.001)were the risk factors for nutritional risk,and both of them were mutually interacted.Conclusions The prevalence of nutritional risk in hospitalized patients in our department was relatively high.Proteinuria was a risk factor for nutritional risk that may cause poor outcome.Regular nutritional screening and early intervention are required for these patients.