每天兩公升1.1%胺基酸透析液對蛋白質熱量營養不良之慢性腹膜透析病人的體位測量和身體組成之影響

Effects of Daily Infusion of 2-L 1.1% Amino Acid Dialysateon Anthropometry and Body Composition of Chronic Peritoneal Dialysis Patients with Protein – Energy Malnutrition

吳紅蓮(Hung-Lien Wu) ； 曾進忠(Chin-Chung Tseng) ； 楊麗芬(Li-Feng Yang) ； 黃建鐘(Jeng-Jong Huang) ； 謝日耀(Ryh-Yaw Hsieh)

《中華民國營養學會雜誌》 29卷2期 (2004/06) Pp. 112-119

https://doi.org/10.6691/JCNS.200406_29(2).0005

摘要

Protein-energy malnutrition, occurring in 44% of chronic uremic patients at the initiation of dialysis, is strongly associated with high morbidity and mortality rates. Many factors can engender the malnutrition, such as protein and amino acid losses in dialysate and inadequate protein intake. A total of 15 chronic peritoneal dialysis patients, with a serum albumin level of 3.5 g/dl and normalized protein equivalent of nitrogen appearance (nPNA) 0.9 gm/kg/day of ideal body weight, were enrolled into this study. And a daily infusion of 2-L 1.1 % amino acid dialysate (Nutrineal(superscript ®)) was administered over six months. There were 12 patients (3 male and 9 female) completed this study. Assessments of serum albumin, anthropometry, and body compositions by dual energy X-ray absorptiometry (DEXA) were performed before and after six months of Nutrineal(superscript ®) treatment. No significant change was found in serum albumin level and subjective global assessment. There were a small, but insignificant, increment of triceps skin fold, and a decrease, but of no significance, in mid-arm muscle circumference or muscle area. Also, there were a trend to decline in lean body mass and a tendency increase in body fat mass before and after six months of Nutrineal(superscript ®) treatment. In addition, bone mineral content did not change during this period. These findings indicated that daily administration of 2-L 1.1% amino acid dialysate for six months in malnourished patients on chronic peritoneal dialysis did not improve the anthropometry and change the body composition.

關鍵字

蛋白質熱量營養不良 ； 腹膜透析 ； 白蛋白 ； 胺基酸透析液 ； 體位測量 ； 身體組成 ； 主觀整體營養評估

並列摘要

Protein-energy malnutrition, occurring in 44% of chronic uremic patients at the initiation of dialysis, is strongly associated with high morbidity and mortality rates. Many factors can engender the malnutrition, such as protein and amino acid losses in dialysate and inadequate protein intake. A total of 15 chronic peritoneal dialysis patients, with a serum albumin level of 3.5 g/dl and normalized protein equivalent of nitrogen appearance (nPNA) 0.9 gm/kg/day of ideal body weight, were enrolled into this study. And a daily infusion of 2-L 1.1 % amino acid dialysate (Nutrineal(superscript ®)) was administered over six months. There were 12 patients (3 male and 9 female) completed this study. Assessments of serum albumin, anthropometry, and body compositions by dual energy X-ray absorptiometry (DEXA) were performed before and after six months of Nutrineal(superscript ®) treatment. No significant change was found in serum albumin level and subjective global assessment. There were a small, but insignificant, increment of triceps skin fold, and a decrease, but of no significance, in mid-arm muscle circumference or muscle area. Also, there were a trend to decline in lean body mass and a tendency increase in body fat mass before and after six months of Nutrineal(superscript ®) treatment. In addition, bone mineral content did not change during this period. These findings indicated that daily administration of 2-L 1.1% amino acid dialysate for six months in malnourished patients on chronic peritoneal dialysis did not improve the anthropometry and change the body composition.

並列關鍵字

protein-energy malnutrition ； peritoneal dialysis ； albumin ； amino acid dialysate ； subjective global assessment ； anthropometry ； body composition