20.500.12556/RUL-122899
Analiza vnosa fosfatov pri dializnih bolnikih
Analysis of phosphate intake in dialysis patients
Evalvacija prehranskega vnosa pri bolnikih na peritonealni dializi je nujna za razumevanje povišanih vrednosti serumskih fosfatov, pa tudi za monitoring beljakovinskega vnosa, ki je zaradi predpisane restrikcije fosfatov glede na smernice praviloma prenizek. 20 bolnikov na peritonealni dializi je bilo naključno izbranih in analiziranih z namenom ugotoviti, kakšen je njihov energijski in hranilni vnos, s poudarkom na beljakovinah in fosfatih. S prehranskim intervjujem smo v obdobju treh mesecev trikrat izvedli metodo priklica jedilnika prejšnjega dne (24-urni priklic) in ga analizirali s spletnim orodjem OPKP. Sestava telesa je bila izmerjena z bioimpendančno spektroskopijo, opravljena je bila tudi biokemijska preiskava krvi. Povprečni energijski vnos 20 bolnikov, z upoštevnim energijskim doprinosom iz dializata, znaša (25,6 ± 6,7) kcal/kg TM/dan, povprečni beljakovinski vnos pa (0,9 ± 0,3) g/kg TM/dan. Glede na priporočila sta prenizka, možno je podcenjeno poročanje bolnikov v prehranskem intervjuju. Povprečni vnos mikrohranil (K, P, Na in Ca) je v referenčnem območju, primernem za dializne bolnike, kar je presenetljivo glede na visoke vrednosti serumskih fosfatov ((1,6 ± 0,4) mmol/L) in intaktnega paratiroidnega hormona ((450 ± 393) ng/L), kar nakazuje na hiperfosfatemijo in sekundarni hiperparatiroidizem. Korelacije med prehranskim vnosom fosfatov in serumskimi fosfati statistično značilno (p = 0,509) nismo zaznali, obstaja pa povezava med vnosom fosfatov in energijskim vnosom (p = 0,0001). Analiza poročanih fosfatov je pokazala, da so bolniki zaužili 60 % beljakovin živalskega izvora in 40 % beljakovin rastlinskega izvora, razmerje med beljakovinami in fosfati je bilo (16 ± 3,6). Anorganski fosfati iz fosfatnih aditivov niso bili zaznani zaradi odsotnosti podatkov v prehranski podatkovni bazi.
Evaluation of the dietary intake in patients on peritoneal dialysis is necessary for understanding of elevated phosphorus levels, as well as protein intake monitoring, which struggles to meet current dietary guidelines. 20 patients on peritoneal dialysis were randomly selected in Dialysis Centre of University Clinical Centre of Ljubljana, with the purpose to detect energy and nutritional intake, especially protein and phosphorus intake. A food propensity questionnaire has been carried out with three unannounced 24-hour dietary recalls per participant through a web-based application “OPEN” and picture book in three months period. Body composition was measured with bio-impedance spectroscopy and biochemical blood tests were performed. Average caloric intake of 20 patients was (25,6 ± 6,7) kcal/kg of body weight per day, dialysate included; average protein intake was (0,9 ± 0,3) g/kg body weight per day. They were inadequate according to the dietary recommendations for dialysis patients on peritoneal dialysis. Average intake of analysed micro-nutrients (K, P, Na) corresponds to the recommendations for dialysis patients which is surprising according to high levels of serum phosphorus (1,6 ± 0,4 mmol/L) and intact parathyroid hormone ((450 ± 393) ng/L). These levels are associated with hyperphosphatemia and secondary hyperparathyroidism. Phosphorus intake was moderately to strongly correlated with the dietary energy intake (p = 0,0001). The correlation between dietary phosphorus intake and serum phosphorus was insignificant (p = 0,509). According to the dietary report, the intake of protein was 60% animal and 40% plant. The ratio of protein intake versus dietary phosphorus was (16 ± 3,6). Inorganic phosphates from additives were not detected due to a lack of information in the database.
prehrana
kronična ledvična bolezen
dializni bolniki
peritonealna dializa
vnos fosfatov
hiperfosfatemija
sekundarni hiperparatiroidizem
metoda jedilnika prejšnjega dne
nutrition
chronic kidney disease
dialysis patients
peritoneal dialysis
phosphate dietary intake
hyperphosphatemia
secondary hyperparatiroidism
24 hour recall
true
false
false
[M. Škrlep]
Slovenski jezik
Angleški jezik
Magistrsko delo/naloga
2020-12-16 07:15:39
2020-12-16 07:15:47
2022-09-03 04:10:18
0000-00-00 00:00:00
2020
0
0
0000-00-00
NiDoloceno
NiDoloceno
NiDoloceno
0000-00-00
0000-00-00
0000-00-00
613.2:616.61
187540
42866691
11462.pdf
11462.pdf
1
AED5365F0CA37DA61ED992E0AF0E74E3
2afc0f66c9d8c0e1ca2491c104ef822db593aed8d205e3209f8610e7751fd9b4
20da0d2c-a1bb-11eb-a523-00155dcfd717
https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=138151
Biotehniška fakulteta
0
0
0