完整營養補充劑對於血液透析患者營養及生理狀況之影響

Effects of complete nutritional supplement on nutritional and physiological status in hemodialysis patients

吳佩瑜(Pei-Yu Wu)

指導教授 ： 謝明哲 ； 楊淑惠

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2005年)

摘要

The present study was designed to evaluate the effect of complete nutritional supplement on selected nutritional and physiological variables in hemodialysis (HD) patients. Nineteen adult HD patients were on regular three times weekly HD for at least 3 months. Patients were followed for a 1-month baseline period, this was before an intervention period, during which, patients were asked to incorporate 100 g of complete nutritional supplement (providing 460 kcal and 18 g protein) daily for 1 month. Patients were reevaluated at third months. A 4 days dietary record was performed over baseline and intervention period. The main outcome measures including anthropometry, blood data, dietary intake, Kt/V, subjective scoring for appetite, and tolerance to supplement were obtained during the 3-month period. Patients incorporated mean 67g complete nutritional supplement over intervention period. This resulted in the energy intake rose to 30 kcal/kg body weight/day (P < 0.05). Following administration of complete nutritional supplement, there were significant increases in concentrations of serum total protein, transferrin, blood urea nitrogen and body fat (P < 0.05). Kt/V, subjective scoring for appetite, the concentrations of blood bicarbonate, and neutrophile count did not change during the study period. Complete nutritional supplement was shown to bring about a significant improvement in some selected nutritional markers such as serum total protein, transferrin, blood urea nitrogen and body fat in chronic HD patients, and does not effect the physiological variables of patients.

關鍵字

血液透析 ； 口服補充劑 ； 營養不良 ； 生理狀況

並列摘要

The present study was designed to evaluate the effect of complete nutritional supplement on selected nutritional and physiological variables in hemodialysis (HD) patients. Nineteen adult HD patients were on regular three times weekly HD for at least 3 months. Patients were followed for a 1-month baseline period, this was before an intervention period, during which, patients were asked to incorporate 100 g of complete nutritional supplement (providing 460 kcal and 18 g protein) daily for 1 month. Patients were reevaluated at third months. A 4 days dietary record was performed over baseline and intervention period. The main outcome measures including anthropometry, blood data, dietary intake, Kt/V, subjective scoring for appetite, and tolerance to supplement were obtained during the 3-month period. Patients incorporated mean 67g complete nutritional supplement over intervention period. This resulted in the energy intake rose to 30 kcal/kg body weight/day (P < 0.05). Following administration of complete nutritional supplement, there were significant increases in concentrations of serum total protein, transferrin, blood urea nitrogen and body fat (P < 0.05). Kt/V, subjective scoring for appetite, the concentrations of blood bicarbonate, and neutrophile count did not change during the study period. Complete nutritional supplement was shown to bring about a significant improvement in some selected nutritional markers such as serum total protein, transferrin, blood urea nitrogen and body fat in chronic HD patients, and does not effect the physiological variables of patients.

並列關鍵字

complete nutritional supplement ； hemodialysis ； nutritional status

參考文獻

Williams and Wilkins, Pennsylvania. Allman MA, Stewart PM, Tiller DJ, Horvath JS, Duggin GG and Truswell AS (1990) Energy supplementation and the nutritional status of hemodialysis patients. Am J Clin Nutr 51: 558-562.

Avram MM, Bonomini LV, Sreedhara R and Mittman N (1996) Predictive value of nutritional markers (albumin, creatinine, cholesterol, and hematocrit) for patients on dialysis for up to 30 years. Am J Kidney Dis Dec 28: 910-917.

Beers MH and Berkow R(1999) Malnutriton. In: The merck manual of diagnosis and therapy (Beers MH and Berkow R, ed.) pp.25-32.

Merck & Co.,Inc, New Jersey. Bellizzi V, Di Iorio BR, Terracciano V, Minutolo R, Iodice C, De Nicola L and Conte G (2003) Daily nutrient intake represents a modifiable determinant of nutritional status in chronic haemodialysis patients. Nephrol Dial Transplant 18: 1874-1881.

Bergstrom J (1999) Mechanisms of uremic suppression of appetite. J Ren Nutr 9: 129-132.