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Analiza prehranskega vnosa in prehranskega statusa dializnih bolnikov: od podhranjenosti do hiperfosfatemije
ID Serdoz, Sara (Avtor), ID Knap, Bojan (Mentor) Več o mentorju... Povezava se odpre v novem oknu

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Izvleček
Redna analiza prehranskega vnosa hemodializnih bolnikov je pomembna za ohranjanje optimalnega prehranskega statusa. Ob pričetku zdravljenja s hemodializo se potrebe po beljakovinah povečajo, medtem ko se omejitve fosfata, kalija in natrija še vedno priporočajo z namenom preventive presnovnih zapletov. Cilj raziskave je bil ugotoviti, ali med pacienti s slabim in dobrim prehranskim statusom obstajajo razlike v prehranskem vnosu ter ali je prehranski vnos zadosten glede na priporočila. Klinično študijo smo izvedli v hemodializnem centru Univerzitetnega kliničnega centra v Ljubljani. Raziskava je potekala v dveh delih. Najprej smo 170 hemodializnim pacientom izmerili sestavo telesa in jim ocenili prehranski status z vidika podhranjenosti in vnetja z vprašalnikom MIS (ang. Malnutrition Inflammation Score). Nato smo izbrali po 28 pacientov z najboljšo in najslabšo oceno MIS in z njimi izvedli prehranski intervju ter ocenili telesno pripravljenost. Zanimal nas je vnos beljakovin, fosforja in kalija, saj so pri tej populaciji pogosto prisotne beljakovinsko energijska podhranjenost, hiperfosfatemija in hiperkalemija. Med skupinama pacientov s slabim in dobrim prehranskim statusom obstajajo statistično značilne razlike v prehranskem vnosu vseh preučevanih parametrov (makrohranila, mikrohranila – P, K, Ca, Na; vnos soli, prehranske vlaknine, sadja in zelenjave). Povprečni vnos energije in beljakovin je v obeh skupinah nezadosten glede na priporočene vrednosti. Korelacije med zaužitim fosforjem s hrano in serumskim fosforjem v krvi ni. Korelacije med zaužitim kalijem s hrano in serumskim kalijem v krvi ni. Rezultati bioimpedančnih meritev, prehranske analize in nizke vrednosti serumskega albumina potrjujejo prisotnost beljakovinsko energijske podhranjenosti. Hemodializni pacienti nujno potrebujejo prehransko svetovanje, saj brez njega ne morejo doseči prehranskih ciljev potrebnih za podporo zdravljenja.

Jezik:Slovenski jezik
Ključne besede:prehrana, prehranski status, kronična ledvična bolezen, hemodializni bolniki, hemodializa, podhranjenost, hiperfosfatemija, sestava telesa, metoda jedilnika prejšnjega dne, analiza prehranskega vnosa
Vrsta gradiva:Magistrsko delo/naloga
Tipologija:2.09 - Magistrsko delo
Organizacija:BF - Biotehniška fakulteta
Kraj izida:Ljubljana
Založnik:[S. Serdoz]
Leto izida:2022
PID:20.500.12556/RUL-142806 Povezava se odpre v novem oknu
UDK:613.24:616.61-78
COBISS.SI-ID:131137283 Povezava se odpre v novem oknu
Datum objave v RUL:27.11.2022
Število ogledov:773
Število prenosov:74
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:Analysis of dietary intake and nutritional status of dialysis patients: from malnutrition to hyperphosphatemia
Izvleček:
Regular analysis of the nutritional intake of hemodialysis patients is important to maintain optimal nutritional status. At the start of hemodialysis treatment, protein requirements increase, while phosphate, potassium and sodium restrictions are still recommended to prevent metabolic complications. The aim of the research was to determine whether there are differences in dietary intake between patients with poor and good nutritional status and whether dietary intake is sufficient according to recommendations. The clinical study was conducted in the hemodialysis center of the University clinical center in Ljubljana. The research was conducted in two parts. First, we measured the body composition of 170 hemodialysis patients and assessed their nutritional status in terms of malnutrition and inflammation using the MIS (Malnutrition Inflammation Score) questionnaire. We then selected 28 patients with the lowest and highest MIS score and conducted a nutritional interview and assessed their physical fitness. We were interested in protein, phosphorus and potassium intake, as protein-energy malnutrition, hyperphosphatemia and hyperkalemia are often present in this population. Between the groups of patients with poor and good nutritional status, there are statistically significant differences in the dietary intake of all studied parameters (macronutrients, micronutrients – P, K, Ca, Na; intake of salt, fiber, fruit and vegetables). The average intake of energy and protein in both groups is insufficient according to the recommended values. There is no correlation between dietary phosphorus intake and blood serum phosphorus or between dietary potassium intake and blood serum potassium. The results of bioimpedance measurements, nutritional analysis and low serum albumin values confirm the presence of protein-energy malnutrition. Hemodialysis patients urgently need nutritional counseling, because without it they cannot achieve the nutritional goals necessary to support the treatment.

Ključne besede:nutrition, nutritional status, chronic kidney disease, hemodialysis patients, hemodialysis, malnutrition, protein energy wasting, hyperphosphatemia, body composition, 24 hour dietary recall, nutritional assessment

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