Vpliv mediteranske diete na serumske vrednosti kalija in fosforja pri bolnikih na peritonealni dializi

Bremec, Neja (author), Knap, Bojan (mentor)

Za bolnike, ki se zdravijo s peritonealno dializo, je pomemben vsakodnevni zadosten energijski vnos ter vnos posameznih makro- in mikrohranil, predvsem beljakovin, kalija, fosforja in natrija. Opažamo, da se bolniki zaradi strahu pred zapleti kronične ledvične bolezni, napačno prehranjujejo. Cilj magistrskega dela je bil ugotoviti, kakšen vpliv ima sprememba prehrane na mediteransko dieto na serumske vrednosti kalija in fosforja, pri bolnikih na peritonealni dializi. Analizirali smo podatke, ki smo jih dobili tekom intervencijske študije, ki je potekala na Centru za peritonealno dializo Kliničnega oddelka za nefrologijo, Univerzitetnega kliničnega centra Ljubljana. Raziskava je potekala v dveh fazah, in sicer pred in po prehranski intervenciji. Intervencija je trajala 4 tedne. V raziskavi je sodelovalo 21 bolnikov na peritonealni dializi, ki so bili naključno razdeljeni v intervencijsko in kontrolno skupino. Bolniki v intervencijski skupini so prejeli spremenjene individualizirane jedilnike, prilagojene smernicam mediteranske diete, ki so primerni za bolnike na peritonealni dializi. Bolniki v kontrolni skupini niso spreminjali prehrane. V obeh skupinah bolnikov ter v obeh fazah raziskave smo opravili prehranski intervju in prehransko analizo, bolnikom smo izmerili telesno sestavo in opravili biokemijsko analizo krvi, bolniki so opravili tudi test moči stiska pesti, test vstani-sedi ter izpolnili Medas vprašalnik. Pri prehranski analizi smo ugotovili, da imajo bolniki v splošnem premajhen dnevni energijski vnos ter vnos beljakovin, premajhen je tudi dnevni vnos natrija, kalija, fosforja, kalcija in magnezija. Bolniki so se zelo dobro držali smernic mediteranske diete. Po intervenciji z mediteransko dieto je bilo v intervencijski skupini bolnikov povprečno število točk Medas vprašalnika statistično značilno višje (p = 0,007). Serumske vrednosti kalija in anorganskega fosfata se po intervenciji z mediteransko dieto niso statistično razlikovale glede na začetno vrednost (p = 0,507 oz. p = 0,286). Ustrezna prehrana je pomemben del zdravljenja bolnikov na peritonealni dializi, zato jo je potrebno spremljati.

• Language: Slovenian
• Keywords: mediteranska dieta, kalij, fosfor, peritonealna dializa, kronična ledvična bolezen, intervencijska študija
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: BF - Biotechnical Faculty
• Publisher: [N. Bremec]
• Year: 2023
• PID: 20.500.12556/RUL-153313
• UDC: 613.2:616.61
• COBISS.SI-ID: 178918403
• Publication date in RUL: 22.12.2023

Secondary language

• Language: English
• Title: Effects of Mediterranean diet on serum levels of potassium and phosphorus in patients on peritoneal dialysis

Abstract

Adequate daily energy intake and the intake of individual macro and micronutrients, especially protein, potassium, phosphorus and sodium, are important for patients undergoing peritoneal dialysis. We observe that patients do not eat properly for fear of complications from chronic kidney disease. The aim of the master's thesis was to find out what effects adherence to the Mediterranean diet has on serum levels of potassium and phosphorus in peritoneal dialysis patients. We analyzed the data obtained during the intervention study, which took place at the Peritoneal Dialysis Center at the Clinical Department of Nephrology of the University Clinical Center Ljubljana. The research was conducted in two phases, before and after the intervention. The intervention lasted 4 weeks. 21 peritoneal dialysis patients participated in the research and were randomly divided into an intervention and a control group. Patients in the intervention group received modified individualized menus adapted to the guidelines of the Mediterranean diet suitable for peritoneal dialysis patients. The diet of the patients in the control group was not changed. In both patient groups and in both phases of the research, we performed a nutritional interview and a nutritional analysis, we measured the body composition of the patients and performed a biochemical blood analysis, the patients also performed a hand grip strength test, a sit-to-stand test and completed the Medas questionnaire. In the nutritional analysis, we found that the patients' daily energy and protein intake were generally too low, as was the daily intake of sodium, potassium, phosphorus, calcium and magnesium. The patients followed very well the guidelines of the Mediterranean diet. After the intervention with the Mediterranean diet, the average score of the Medas questionnaire was statistically significantly higher in the intervention group of patients (p = 0.007). Serum levels of potassium and of inorganic phosphate were not statistically different from the baseline after the Mediterranean diet intervention (p = 0,507 and p = 0,286). Adequate nutrition is an important part of the treatment of patients undergoing peritoneal dialysis, so it is necessary to monitor it.

• Keywords: Mediterranean diet, potassium, phosphorus, peritoneal dialysis, chronic kidney disease, intervention study