Whole body and regional body composition in patients with chronic renal failure.
Whole body and regional body composition in patients with chronic renal failure.
复制标题
慢性肾功能衰竭患者的全身和局部身体成分。
DOI：
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发表时间：
1996
影响因子：
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通讯作者：
Michael A. Smith
中科院分区：
文献类型：
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作者：
G. Woodrow;B. Oldroyd;J. Turney;L. Tompkins;A. Brownjohn;Michael A. Smith
背景
营养状况是慢性肾功能衰竭（CRF）的重要预后因素。营养评估技术有局限性，这在肾脏疾病的存在下往往最为明显。我们使用身体成分分析技术来评估CRF患者的营养状况。
方法
测量接受保守治疗、腹膜透析和血液透析的晚期CRF患者的身体成分，并将结果与健康对照组进行比较。CRF患者的选择标准确保他们“稳定”，近期无并发疾病，根据目前接受的目标，透析充分性令人满意。
结果
全身双能X线吸收法（DEXA）发现血液透析患者和女性腹膜透析患者的瘦组织显著减少。DEXA的区域分析显示CRF患者的肢体（尤其是手臂）和瘦组织减少，所有三个CRF组女性和两个透析组男性的手臂瘦组织减少。所有CRF组的四肢/躯干瘦肉组织比均显著降低。生物电阻抗显示，在用DEXA减少全身瘦组织的相同组中，无脂肪质量减少，但皮褶人体测量法未能检测到无脂肪质量的任何显着减少。
结论
我们的结论是，即使在“健康”组的CRF患者接受充分的透析和饮食管理，瘦组织消耗是一个常见的问题。在CRF患者中，通过DEXA进行区域分析并测量肢体瘦组织质量是检测瘦组织消耗比测量全身瘦组织更敏感的方法。
BACKGROUND
Nutritional state is a powerful prognostic factor in chronic renal failure (CRF). Techniques for the assessment of nutrition have limitations which are often most marked in the presence of renal disease. We have used techniques of body composition analysis to assess the nutritional state of groups of patients with CRF.
METHODS
Body composition was measured in groups of patients with advanced CRF on conservative treatment, peritoneal dialysis, and haemodialysis and the results compared with a healthy control group. The selection criteria for the CRF patients ensured that they were "stable' with no recent intercurrent illness, and dialysis adequacy was satisfactory according to currently accepted targets.
RESULTS
Whole body dual energy X-ray absorptiometry (DEXA) found significant reduction in lean tissue in haemodialysis patients and female peritoneal dialysis patients. Regional analysis with DEXA showed reduction in limb (especially arm), lean tissue in CRF patients, with arm lean tissue being reduced in all three CRF groups for females and both dialysis groups for males. Limb/trunk lean tissue ratios were significantly reduced for all CRF groups. Bioelectrical impedance showed reductions of fat-free mass in the same groups who had reduced whole body lean tissue with DEXA, but skinfold anthropometry failed to detect any significant reduction in fat-free mass.
CONCLUSIONS
We conclude that even in "healthy' groups of CRF patients receiving adequate dialytic and dietary management, lean tissue depletion is a common problem. Regional analysis by DEXA, with measurement of limb lean tissue mass is a more sensitive method for the detection of lean tissue depletion than measurement of whole body lean tissue in patients with CRF.