Nutritional Risk Screening in patients with chronic kidney disease

慢性肾脏病患者的营养风险筛查研究

Rongshao Tan ； Jianting Long ； Shi Fang ； Haiyan Mai ； Wei Lu ； Yan Liu ； Jianrui Wei ； Feng Yan

《Asia Pacific Journal of Clinical Nutrition》 25卷2期 (2016/06) Pp. 249-256

https://doi.org/10.6133/apjcn.2016.25.2.24

摘要

目前人们对于慢性肾脏病患者（CKD）的营养状况了解非常有限。根据欧洲临床营养与代谢协会推荐，营养风险筛查标准NRS-2002已被广泛应用于评估其他疾病患者的营养风险。本研究旨在利用NRS-2002评估CKD患者的营养风险。我们针对292例未经过透析的CDK患者进行了NRS-2002评估，记录了他们的体重指数（BMI）和各种生化指标，并对NRS-2002评分与各种指标之间的相关性进行了分析。在所有样本中，处于营养风险状态的患者比例为44.9%（CKD 4-5级患者中比例为53.6%，1-3 级为38.3%）。血清白蛋白、血红蛋白B 和淋巴细胞计数与患者的营养风险状态显著相关。在主治医师未得知NRS-2002评分的状况下，仅有35.1%存在营养风险的患者接受了营养支持治疗。患者的营养风险状况与其初诊类型无关。本研究结果表明，临床实践中应该重视CKD患者（包括早期病人）的营养状况，及时给予营养治疗。我们建议针对非透析的CKD患者使用NRS-2002进行营养风险评估。

關鍵字

营养状况 ； 营养风险筛查2002 ； 慢性肾病 ； 营养支持 ； 营养失调

並列摘要

Knowledge concerning nutritional status of patients with chronic kidney disease (CKD) is limited. Nutritional Risk Screening-2002 (NRS-2002) has been used to evaluate the nutritional aspects of patients according to the recommendation of European Society for Clinical Nutrition and Metabolism. Here we aim to assess the prevalence and characteristics of nutritional risk in CKD patients by using NRS-2002. NRS-2002 scores of 292 CDK patients were recorded in first 24 hours subsequent to their admission to hospital. All patients have never been on dialysis. BMI, weight and various biochemical parameters were also characterized for these patients. Possible correlations between these parameters and NRS-2002 score were investigated. The overall prevalence of nutritional risk was 44.9% (53.6% in CKD stage 4-5 patients and 38.3% in stage 1-3 patients). Statistically significant differences were found in serum Albumin, Haemoglobin B, and lymphocyte counts between patients with or without increased nutritional risk. Under the situation that attending physicians were completely unaware of NRS-2002 scores, only 35.1% of the patients at risk received nutritional support. The nutritional risk status was associated with CKD stages but independent from primary diagnosis type. More attention should be paid to the nutritional status in CKD patients (including early stage patients). We recommended using NRS-2002 for nutritional risk assessment among non-dialysis CKD patients in routine clinical practice.

並列關鍵字

nutrition ； nutritional risk screening 2002 ； chronic kidney disease ； nutritional support ； malnutrition