Nutritional counseling regulates interdialytic weight gain and blood pressure in outpatients receiving maintenance hemodialysis
Nutritional counseling regulates interdialytic weight gain and blood pressure in outpatients receiving maintenance hemodialysis
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DOI：
10.2152/jmi.64.129
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发表时间：
2017-02-01
影响因子：
0.7
通讯作者：
Nikawa, Takeshi
中科院分区：
文献类型：
--
作者：
Sakai, Atsuko;Hamada, Hisayo;Nikawa, Takeshi
维持性血液透析门诊患者必须限制盐和水的摄入量，以维持电解质平衡和血压。在川岛医院，国家注册营养师每月为血液透析患者提供营养咨询。我们调查了营养咨询是否影响透析间期体重增加 (IDWG) 和血压。我们调查了48名每月平均IDWG与干重之比超过5.1%且没有长期住院1个月的血液透析患者。经过 48 个月的营养咨询期后，37 名患者 (77.1%) 的 IDWG 比率有所改善，从 6.0 +/- 0.7 显着下降至 5.3 +/- 0.9%。预计盐和水的摄入量分别从 13.3 +/- 2.7 显着减少至 11.8 +/- 2.4 克/天，从 2528 +/- 455 显着减少至 2332 +/- 410 毫升/天。在干预期间，标准化蛋白质分解代谢率和体重指数没有显着变化。研究开始后 48 个月内，血液透析前的收缩压和舒张压分别从 149 +/- 19 毫米汞柱显着降低至 134 +/- 18 毫米汞柱，从 82 +/- 13 毫米汞柱显着降低至 75 +/- 10 毫米汞柱。在 IDWG 比率改善的组中，抗高血压药物的剂量显着减少。国家注册营养师的长期营养咨询可以通过减少盐和水的摄入量来改善血液透析患者的IDWG比和血压。
Maintenance hemodialysis outpatients must limit salt and water intake to maintain electrolyte balance and blood pressure. In Kawashima Hospital, nationally registered dietitians provide hemodialysis patients with monthly nutritional counseling. We investigated whether nutritional counseling affects interdialytic weight gain (IDWG) and blood pressure. We investigated 48 hemodialysis patients whose monthly average IDWG ratio to dry weight exceeded 5.1% and who had not had a long-term hospital admittance of 1 month. After the 48-month nutritional counseling period, the IDWG ratio had improved in 37 of the patients (77.1%), significantly decreasing from 6.0 +/- 0.7 to 5.3 +/- 0.9%. Estimated salt and water intake decreased significantly from 13.3 +/- 2.7 to 11.8 +/- 2.4 g/day and 2528 +/- 455 to 2332 +/- 410 ml/day, respectively. During the intervention period, normalized protein catabolic rate and body mass index did not change substantially. Pre-hemodialysis systolic and diastolic blood pressures had significantly decreased from 149 +/- 19 to 134 +/- 18 mmHg, and 82 +/- 13 to 75 +/- 10 mmHg for 48 months after study initiation, respectively. The dosage of antihypertensive drugs had significantly decreased in the group that experienced improvement in the IDWG ratio. Long-term nutritional counseling by nationally registered dietitians may improve the IDWG ratio and blood pressure of hemodialysis patients by decreasing their salt and water intake.