Analysis of nutritional risk in inpatients with chronic kidney disease_West China Medical Journal

Authors：

LI Jing , LUO Yan , RUAN Yi , LI Ling , MA Dengyan ,  DIAO Yongshu

Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

DIAO Yongshu, Email: dszhbf@163.com

Keywords：

Chronic kidney disease; Nutritional risk; Nutritional Risk Screening 2002

DOI：

10.7507/1002-0179.201905245

Video：

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Objective To explore the nutritional status of inpatients with chronic kidney disease (CKD) and analyze the factors affecting nutritional risk, to provide theoretical basis for further nutritional support.Methods Convenience sampling method was adopted to select 719 inpatients with CKD as research subjects in a tertiary hospital in Chengdu, Sichuan Province from January to March 2018. Nutritional Risk Screening 2002 was used for nutritional risk screening, and chi-square test, t test, one-way analysis of variance, and multiple linear regression analysis were used to explore the influencing factors of nutritional risk.Results Among the 719 cases, whose average nutritional risk score was 1.79±1.11, 158 cases had nutritional risk, accounting for 22.0%. There were statistically significant differences in nutritional risk score between patients of age<60 years and ≥60 years, between males and females, between patients with CKD stage 1-3 and stage 4-5, between patients with serum albumin level <30 g/L and ≥30 g/L, and between patients with and without anaemia (P<0.05). The results of multiple linear regression analysis showed that the nutritional risk score of CKD patients was negatively correlated to serum albumin level (P=0.016), positively correlated to age (P<0.001), and higher in females than that in males (P=0.001).Conclusions Inpatients with CKD have a higher nutritional risk, with age, gender and serum albumin as the main influencing factors. Based on the above factors, the medical staff should continue to take targeted intervention measures to assess the nutritional status of CKD inpatients early and conveniently, so as to provide scientific basis for further nutritional support and nutritional nursing.

Citation： LI Jing, LUO Yan, RUAN Yi, LI Ling, MA Dengyan, DIAO Yongshu. Analysis of nutritional risk in inpatients with chronic kidney disease. West China Medical Journal, 2019, 34(8): 933-937. doi: 10.7507/1002-0179.201905245 Copy

1.	陳麗, 朱芳蓉, 蘇曉燕, 等. 慢性腎臟病管理整體模式對改善終末期腎病蛋白能量消耗患者營養狀況的作用. 齊魯護理雜志, 2018, 24(17): 66-68.
2.	K/DOQI, National Kidney Foundation. Clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis, 2000, 35(6 Suppl 2): S17-S104.
3.	陳博, 周勇, 楊平, 等. 重視營養風險篩查在住院患者中的實施. 中國普外基礎與臨床雜志, 2011, 18(12): 1262-1264.
4.	Kondrup J, Rasmussen HH, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3): 321-336.
5.	中華醫學會腸外腸內營養學分會. 臨床診療指南: 腸外腸內營養學分冊. 北京: 人民衛生出版社, 2006: 15-19.
6.	National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-S266.
7.	蔣朱明, 陳偉, 朱賽楠, 等. 我國東、中、西部大城市三甲醫院營養不良(不足)、營養風險發生率及營養支持應用狀況調查. 中國臨床營養雜志, 2008, 16(6): 335-337.
8.	方仕, 麥海妍, 盧味, 等. 住院患者營養風險篩查及營養支持狀況. 中國公共衛生, 2010, 26(5): 574-575.
9.	孔倩, 仇建國, 李宇華, 等. 湛江某醫院383例老年住院患者不同性別營養狀況分析. 海軍醫學雜志, 2015, 36(5): 438-440.
10.	張繼紅, 黃蕾, 宋寶梅, 等. 心血管內科老年住院患者營養風險分析及護理. 護理學報, 2011, 18(18): 32-34.
11.	中華醫學會腸外腸內營養學分會老年營養支持學組. 老年患者腸外腸內營養支持中國專家共識. 中華老年醫學雜志, 2013, 32(9): 913-929.
12.	趙曉云, 劉瑤, 趙雅寧. 維持性血液透析患者營養風險與醫學應對方式相關性分析. 華北理工大學學報(醫學版), 2018, 20(3): 233-238.
13.	李臻. 某三甲醫院住院患者營養風險及營養支持情況調查分析. 太原: 山西醫科大學, 2017.
14.	陳慧玉, 陳品儒, 肖芃, 等. 非結核分枝桿菌肺病患者營養風險篩查及營養支持狀況的分析. 廣州醫藥, 2016, 47(4): 57-59.
15.	王倩. 維持性血液透析患者營養風險影響因素分析. 唐山: 華北理工大學, 2016.
16.	Fouque D, Vennegoor M, Ter Wee P, et al. EBPG guideline on nutrition. Nephrol Dial Transplant, 2007, 22(Suppl 2): ii45-ii87.
17.	丁小萍, 邢小紅, 陳靜, 等. 1813例腎臟病患者營養風險的篩查. 解放軍護理雜志, 2015, 32(22): 74-76.
18.	李麗. 慢性腎臟病患者臨床營養評估及膳食結構特點分析. 重慶: 第三軍醫大學, 2015.
19.	孔建華, 張潔, 滑瑩瑩, 等. 老年慢性腎臟病患者營養風險篩查及分析. 中國老年學雜志, 2016, 36(22): 5711-5713.
20.	Shah BV, Patel ZM. Role of low protein diet in management of different stages of chronic kidney disease - practical aspects. BMC Nephrol, 2016, 17(1): 156.
21.	黃媛媛, 鄭丹俠, 王悅. 慢性腎臟病低蛋白飲食的研究進展. 醫學綜述, 2018, 24(24): 4869-4873.
22.	曾艷, 鞏紅飛, 柴峰, 等. 慢性腎臟病營養治療研究進展. 甘肅醫藥, 2018, 37(4): 308-310.
23.	劉曄, 歐陽曉俊, 蔡曉真, 等. 內科老年住院患者營養狀況及其影響因素分析. 中國臨床保健雜志, 2019, 22(2): 174-178.
24.	何璐晨, 張紅梅, 常立陽, 等. 慢性腎臟病患者營養狀況的調查與分析. 護理與康復, 2017, 16(3): 225-229.
25.	Spiegel BM, Melmed G, Robbins S, et al. Biomarkers and health-related quality of life in end-stage renal disease: a systematic review. Clin J Am Soc Nephrol, 2008, 3(6): 1759-1768.

1. 陳麗, 朱芳蓉, 蘇曉燕, 等. 慢性腎臟病管理整體模式對改善終末期腎病蛋白能量消耗患者營養狀況的作用. 齊魯護理雜志, 2018, 24(17): 66-68.
2. K/DOQI, National Kidney Foundation. Clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis, 2000, 35(6 Suppl 2): S17-S104.
3. 陳博, 周勇, 楊平, 等. 重視營養風險篩查在住院患者中的實施. 中國普外基礎與臨床雜志, 2011, 18(12): 1262-1264.
4. Kondrup J, Rasmussen HH, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3): 321-336.
5. 中華醫學會腸外腸內營養學分會. 臨床診療指南: 腸外腸內營養學分冊. 北京: 人民衛生出版社, 2006: 15-19.
6. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-S266.
7. 蔣朱明, 陳偉, 朱賽楠, 等. 我國東、中、西部大城市三甲醫院營養不良(不足)、營養風險發生率及營養支持應用狀況調查. 中國臨床營養雜志, 2008, 16(6): 335-337.
8. 方仕, 麥海妍, 盧味, 等. 住院患者營養風險篩查及營養支持狀況. 中國公共衛生, 2010, 26(5): 574-575.
9. 孔倩, 仇建國, 李宇華, 等. 湛江某醫院383例老年住院患者不同性別營養狀況分析. 海軍醫學雜志, 2015, 36(5): 438-440.
10. 張繼紅, 黃蕾, 宋寶梅, 等. 心血管內科老年住院患者營養風險分析及護理. 護理學報, 2011, 18(18): 32-34.
11. 中華醫學會腸外腸內營養學分會老年營養支持學組. 老年患者腸外腸內營養支持中國專家共識. 中華老年醫學雜志, 2013, 32(9): 913-929.
12. 趙曉云, 劉瑤, 趙雅寧. 維持性血液透析患者營養風險與醫學應對方式相關性分析. 華北理工大學學報(醫學版), 2018, 20(3): 233-238.
13. 李臻. 某三甲醫院住院患者營養風險及營養支持情況調查分析. 太原: 山西醫科大學, 2017.
14. 陳慧玉, 陳品儒, 肖芃, 等. 非結核分枝桿菌肺病患者營養風險篩查及營養支持狀況的分析. 廣州醫藥, 2016, 47(4): 57-59.
15. 王倩. 維持性血液透析患者營養風險影響因素分析. 唐山: 華北理工大學, 2016.
16. Fouque D, Vennegoor M, Ter Wee P, et al. EBPG guideline on nutrition. Nephrol Dial Transplant, 2007, 22(Suppl 2): ii45-ii87.
17. 丁小萍, 邢小紅, 陳靜, 等. 1813例腎臟病患者營養風險的篩查. 解放軍護理雜志, 2015, 32(22): 74-76.
18. 李麗. 慢性腎臟病患者臨床營養評估及膳食結構特點分析. 重慶: 第三軍醫大學, 2015.
19. 孔建華, 張潔, 滑瑩瑩, 等. 老年慢性腎臟病患者營養風險篩查及分析. 中國老年學雜志, 2016, 36(22): 5711-5713.
20. Shah BV, Patel ZM. Role of low protein diet in management of different stages of chronic kidney disease - practical aspects. BMC Nephrol, 2016, 17(1): 156.
21. 黃媛媛, 鄭丹俠, 王悅. 慢性腎臟病低蛋白飲食的研究進展. 醫學綜述, 2018, 24(24): 4869-4873.
22. 曾艷, 鞏紅飛, 柴峰, 等. 慢性腎臟病營養治療研究進展. 甘肅醫藥, 2018, 37(4): 308-310.
23. 劉曄, 歐陽曉俊, 蔡曉真, 等. 內科老年住院患者營養狀況及其影響因素分析. 中國臨床保健雜志, 2019, 22(2): 174-178.
24. 何璐晨, 張紅梅, 常立陽, 等. 慢性腎臟病患者營養狀況的調查與分析. 護理與康復, 2017, 16(3): 225-229.
25. Spiegel BM, Melmed G, Robbins S, et al. Biomarkers and health-related quality of life in end-stage renal disease: a systematic review. Clin J Am Soc Nephrol, 2008, 3(6): 1759-1768.

West China Medical Journal

Analysis of nutritional risk in inpatients with chronic kidney disease

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