Glucose Absorption in Nephropathy Patients Receiving Continuous Ambulatory Peritoneal Dialysis

持续非卧床腹膜透析肾病病人的葡萄糖吸收

Xue-Zhi Zuo ； Xiaolei Ye ； Fang-Yun Sun ； Kun Qian ； Siyun Xiang ； Wang-Qun Liang ； Gang Xu ； Ying Yao ； Chen-Jiang Ying

《Asia Pacific Journal of Clinical Nutrition》 24卷3期 (2015/09) Pp. 394-402

https://doi.org/10.6133/apjcn.2015.24.3.16

摘要

目的：从透析液中吸收的葡萄糖不仅会造成腹膜透析病人能量失衡，还会对机体产生毒性作用。但目前广泛应用的葡萄糖吸收量估算公式可能不适合中国的持续性非卧床腹膜透析（CAPD）病人。本文在一个CAPD队列中探讨四种估算方法与实测值的差异。方法：测量72例CAPD病人透析液来源的葡萄糖吸收量，并与K/DOQI公式、Grodstein公式、Bodnar公式以及60%葡萄糖吸收率公式的估算结果进行比较。结果：CAPD病人每日使用的透析液所含葡萄糖总量平均为102 ± 27.9 g（范围54.4到191 g）。葡萄糖吸收量实际测量值平均为65.7 ± 23.3 g（范围19.5到131g），平均吸收率为64.4%（范围30.6%到92.4%），透析液来源的葡萄糖供能占总能量的比例为13.8%（范围5.0%到30.1%）。实际测量值与四种不同公式估算值平均差值大于10 g 或20g（p ＜ 0.001），平均差值百分比大于20%或40%（p ＜ 0.001）。结论：目前应用的葡萄糖吸收量估算方法存在局限性，与目前使用的估计方法相比，实际测量值可以更准确地为营养师和医生提供葡萄糖和能量的吸收信息。

關鍵字

葡萄糖吸收 ； 实际测量 ； 估算方法 ； 持续非卧床腹膜透析 ； 膳食调查

並列摘要

Objectives: Peritoneal dialysis patients are at risk of glucose absorption from peritoneal dialysate, not only because of energy imbalance but also the toxic effects of high glucose. The current widely applied formulae may be not suitable for estimation of glucose absorption in continuous ambulatory peritoneal dialysis (CAPD) patients. This study examined the actual glucose absorption in a cohort of CAPD patients and compared the results with estimates from four current formulae. Methods: We conducted a survey of glucose absorption of a cohort of 72 CAPD patients and compared actual dialysate glucose absorbed and estimates using K/DOQI formula, ＂Grodstein＂ formula, ＂Bodnar＂ formula, or a percentage estimate of 60%. Results: The total dialysate glucose infused each day varied from 54.4 to 191 g/day with average of 102 ± 27.9 g. The average of glucose absorbed was 65.7 g (ranging from 19.5 to 131 g) by actual measurements. The mean absorption rate was 64.4% (ranging from 30.6% to 92.4%). The glucose absorbed from dialysate accounted for 13.8% (ranging from 5.0% to 30.1%) of total energy intake. The average errors of absolute values between actual measurements and estimates were greater than 10 g or 20 g glucose (p ＜ 0.001). The average errors in percentages were greater than 20% or 40%, dependently on estimating methods. Conclusions: The applications of current estimating methods may have limitations. The actual measurement provides dietitians and doctors with more exact information of absorbed glucose and energy compared to the current estimating methods.

並列關鍵字

glucose absorption ； actual measurement ； estimating methods ； continuous ambulatory peritoneal dialysis ； dietary survey