慢性肾脏病3～4期患者营养状态分析

目的以北京市慢性肾脏病3期、4期的患者为研究对象，调查其营养状况，探讨可能存在的营养治疗措施。方法根据估算肾小球滤过率水平选取患者129例。利用改良主观综合性营养评估患者营养状况，与患者的膳食结构进行相关分析。结果患者血清白蛋白≤38g／L的患者占12．4％。随着慢性肾脏病的进展，低白蛋白血症患者的发生率增加。根据患者的改良主观综合性营养评分分成两组，营养较差组占11．6％，该组患者不仅蛋白摄入低，并且优质蛋白所占比例明显较少。结论慢性肾脏病3期和4期的患者营养不良的发生率较低。营养不良与患者的肾功能恶化相关。营养不良的肾脏病患者改善摄入蛋白质的结构，增加优质蛋白的比例有望改善这部分患者的营养状况。

Analysis of nutritional status in patients with chronic kidney disease at stage 3 and 4

Objective To investigate the nutrition support and by analyzing the status of nutritional status in chronic kidney disease （CKD） patients at stage 3 and 4. Methods 129 CKD patients at stage 3 and 4 were enrolled. The glomerular filtration rate（GFR）was estimated from the modification of diet in renal disease （MDRD） study equation. Nutritional parameters were analyzed by modified subjective global nutritional assessment（mSGA）. Results The percentage of the CKD patients with serum albumin concentration blow 38 g/L was 12.4%. The CKD patients at stage 4 had lower level of serum albumin than at stage 3. According to mSGA, malnutrition rate in those CKD patients was 11.6%. In the malnutrition group,the intake of calorie and protein was lower than that in the normal nutritional group. It was found that the protein intake of these patients was mainly from the plant, especially in the malnutrition group. Conclusions In the early stage of CKD, the malnutrition rate was low. The nutrition status was correlated with the renal function. Although the patients with CKD had reduced protein intake, the quality of protein was far from the high biological value.