老年慢性肾脏病非透析患者优质低蛋白饮食的依从性现状及影响因素分析

Status and Influencing Factors of Compliance with High-quality Low protein Diet in Non-dialysis Elderly Patients with Chronic Kidney Disease

目的调查老年慢性肾脏病非透析患者优质低蛋白饮食依从性现状,分析其相关影响因素。方法采用便利抽样的方法回顾性选取江苏省省级机关医院肾内科病房于2022年1月—2023年1月收治的92例慢性肾病非透析患者的临床资料,按照是否执行优质低蛋白饮食进行分组(执行组63例和未执行组29例)。统计分析两组患者的基线资料和临床指标,并通过单因素和多因素Logistic回归分析影响老年慢性肾脏病非透析患者执行优质低蛋白饮食的因素。结果执行组患者无高血压(52例)、接受过饮食宣教(46例)明显多于未执行组,差异有统计学意义(χ^(2)=9.531、12.372,P均<0.05)。多因素Logistic回归分析结果显示,是否患有高血压、是否接受过饮食宣教、自我效能的高低是影响老年慢性肾脏病非透析患者执行优质低蛋白饮食的独立影响因素(OR=1.341、1.560、1.649,P均<0.05)。结论老年慢性肾脏病非透析患者执行优质低蛋白饮食的自觉性不高,其主要受是否患有高血压、是否接受过饮食宣教、自我效能的高低的影响,临床可在这3个方面加强对患者的指导干预,提高老年慢性肾脏病非透析患者进行优质低蛋白饮食的执行力。

Objective To investigate the compliance status of high-quality low-protein diet in elderly patients with chronic kidney disease without dialysis,and to analyze the relevant influencing factors.Methods Clinical data of 92 non-dialysis patients with chronic kidney disease admitted to the nephrology ward of Jiangsu Provincial Government Hospital from January 2022 to January 2023 were retrospectively selected by convenience sampling,and grouped according to whether or not they implemented a high-quality low-protein diet(63 cases in the implementation group and 29 cases in the non-implementation group).The baseline data and clinical parameters of the two groups were statistically analyzed,and the factors influencing the implementation of a high-quality low-protein diet in elderly chronic kidney disease non-dialysis patients were analyzed by univariate and multivariate Logistic regression.Results Patients in the implementation group had no hypertension(52 cases)and had received diet education(46 cases),which were significantly more than those in the non-implementation group,and the differences were statistically significant(χ^(2)=9.531,12.372,both P<0.05).Multivariate Logistic regression analysis showed that hypertension,diet education and self-efficacy were independent factors affecting the implementation of high-quality low-protein diet in non-dialysis elderly patients with chronic kidney disease(OR=1.341,1.560,1.649,all P<0.05).Conclusion The consciousness of elderly non-dialysis patients with chronic kidney disease to implement high-quality low-protein diet is not high,which is mainly affected by whether they have hypertension,whether they have received diet education,and the level of self-efficacy.Clinical guidance and intervention for patients in these three aspects can be strengthened to improve the execution of high-quality low-protein diet for elderly non-dialysis patients with chronic kidney disease.