低蛋白及低GI管灌配方介入慢性腎衰竭患者之腎功能及血糖改善評估

The effect of low protein and low glycemic index nutrition formula intervention on improving renal function and blood glucose in chronic renal failure patients

賴馥君(Fu-Chun Lai)

指導教授 ： 王進崑

中山醫學大學/健康管理學院/營養學系碩士班/碩士(2015年)

摘要

台灣罹患慢性腎臟疾病的患者高達12%，平均每8位成年人就有一位罹患此慢性疾病，其中洗腎人口約5至6萬人，是全球之冠，造成醫療費用的過度支出，若能有效的減緩慢性腎臟疾病病程的進展，才能減少患者進入末期腎病的階段。
適當的飲食與營養的充足是決定腎臟病惡化成敗的重要關鍵，包括了充足的熱量，維他命及蛋白質的攝取，鹽份以及水份的平衡。本試驗使用低蛋白營養配方，補充於未洗腎的急性及慢性腎衰竭患者、尿毒症患者、糖尿病腎病變患者、限制蛋白質飲食計畫者，測試低蛋白營養配方產品之補充對這些病人的營養狀況促進減少腎臟病惡化的發生並進一步評估腎功能狀況改善之成效。
本研究全程參與完成試驗的受試者共計38位（男性15位，女性23位），受試者皆為全管灌的安養中心住民，給予全日營養所需之全管灌低蛋白質配方。經過12週後，醣化血色素由7.58±1.51％ 顯著下降為5.88±0.48％、尿素氮由26.92±11.81 mg/dL顯著下降為11.08±4.44；尿中尿素氮、尿酸皆有顯著下降，膽固醇與三酸甘油酯亦有顯著差異，但在肝功能與血球部分皆無影響。
故使用低蛋白飲食對於腎功能不佳的患者可以減少尿素氮，並控制血糖、血脂，可成為腎疾病患者重要治療方針之一。

關鍵字

慢性腎臟病 ； 低蛋白 ； 低GI

並列摘要

Taiwanese suffer from chronic kidney disease up to 12%. On average, every eight adµLts have this chronic disease. There are about 5-6 million people using dialysis in Taiwan, which is the highest in the world. The high prevalence of chronic kidney diseases makes excessive medical expenses. If slowing the progression of chronic kidney disease effectively, the expenses coµLd be reduced.
Offering proper diet and adequate nutrition is the key to determine the progress of kidney disease, such as adequate calories, vitamins, protein, salt, and water. This study offered very low protein formµLa to patients, who suffered non-dialysis renal failure, uremia, diabetic nephropathy or requiring limiting protein diet patients. The patients' nutritional status and renal function were determined.
In this study, 38 subjects (males 15, females 23) with tube feeding in nursing home were completely involved. Very low protein formµLa was given for 12 weeks. ResµLts showed HbA1c was significantly reduced from 7.58 ± 1.51% to 5.88 ± 0.48%, and urea nitrogen was greatly reduced from 26.92 ± 11.81 mg / dL to 11.08 ± 4.44. Urinary nitrogen and uric acid showed significant difference. Cholesterol and triglyceride levels also showed significant difference. However, liver function and blood cells were not changed.
In summary, very low protein formµLa for renal dysfunction patients coµLd reduce urinary nitrogen and well controlled blood sugar and lipids. It coµLd be an important therapeutic strategy for patients with chronic kidney diseases.

並列關鍵字

chronic kidney diseases ； low protein ； low glycemic index

參考文獻

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