每天兩公升1.1%胺基酸透析液對蛋白質熱量營養不良之慢性腹膜透析病人的體位測量和身體組成之影響

Abstract

Protein-energy malnutrition, occurring in 44% of chronic uremic patients at the initiation of dialysis, is strongly associated with high morbidity and mortality rates. Many factors can engender the malnutrition, such as protein and amino acid losses in dialysate and inadequate protein intake. A total of 15 chronic peritoneal dialysis patients, with a serum albumin level of 3.5 g/dl and normalized protein equivalent of nitrogen appearance (nPNA) 0.9 gm/kg/day of ideal body weight, were enrolled into this study. And a daily infusion of 2-L 1.1 % amino acid dialysate (Nutrineal(superscript ®)) was administered over six months. There were 12 patients (3 male and 9 female) completed this study. Assessments of serum albumin, anthropometry, and body compositions by dual energy X-ray absorptiometry (DEXA) were performed before and after six months of Nutrineal(superscript ®) treatment. No significant change was found in serum albumin level and subjective global assessment. There were a small, but insignificant, increment of triceps skin fold, and a decrease, but of no significance, in mid-arm muscle circumference or muscle area. Also, there were a trend to decline in lean body mass and a tendency increase in body fat mass before and after six months of Nutrineal(superscript ®) treatment. In addition, bone mineral content did not change during this period. These findings indicated that daily administration of 2-L 1.1% amino acid dialysate for six months in malnourished patients on chronic peritoneal dialysis did not improve the anthropometry and change the body composition.