J RENAL NUTR:临床实践中记录的食物入量和24小时尿液收集是否一致?

2022-03-13 MedSci原创 MedSci原创

3天饮食记录是确定患者饮食模式的有用工具,但在临床环境中评估特定营养摄入时应谨慎使用。

准确评估营养素和食物摄入量在肾脏病实践中至关重要。2020年肾病结果质量改善倡议(KDOQI)建议将3-5期慢性肾病患者的钠摄入量限制在2300毫克,蛋白质摄入量限制在0.55-0.9克/千克体重。这些指南还建议患者使用地中海饮食以改善脂质状况,并多吃水果和蔬菜处方以改善体重、血压和减少净酸生成。

在更严重的肾脏疾病中,如果血清值升高,还需要限制钾和磷的摄入。钠、蛋白质、钾和磷以及钙、镁和液体的摄入在许多肾病疾病中起着关键作用,包括慢性肾病、进行性囊性疾病、肾结石、高血压和蛋白尿。为了提供个性化的营养建议,必须评估这些营养素的摄入量,以确定患者当前的摄入量是否超过每日建议。

本研究的目的是确定作为临床护理的获得的3天饮食记录与24小时尿液收集之间的一致性水平,特别是评估钠、钾、磷、钙、蛋白质和液体摄入量。

数据是从一个学术医疗中心的肾病诊所收集的。对完成3天饮食记录和24小时尿液收集的患者进行分析。使用简单比率、皮尔逊相关和一般线性模型对食物记录和尿液收集测量进行比较。

研究结果显示,患者(n=85)年龄为47.9±15.2岁,54%为女性,平均血清肌酐为1.3±0.7 mg/dL,估计肾小球滤过率为64.2±25.6 mL/min。患者有常染色体显性多囊肾病(48.2%),肾结石(31.1%),慢性肾病(4.7%),或影响肾脏的其他遗传或囊性疾病(12.9%)。营养摄入量是通过3天的食物记录来测量的。使用数值、相关性和一般线性模型比较食物记录和尿液收集。

膳食摄入与24小时尿液收集排泄的比率

液体摄入的一致性最高(比率1.01),钙的一致性最低(比率6.30)。磷(r=0.321,P=0.003)、镁(r=0.256,P=0.018)、蛋白质(r=0.555,P<0.000)和液体(r=0.277,P=0.010)摄入量之间存在显著相关性。钾(P=0.046)、蛋白质(P=0.004)和液体(P=0.010)的食物记录摄入量是24小时尿液排泄的重要预测因子。

简单来说,3天饮食记录是确定患者饮食模式的有用工具,但在临床环境中评估特定营养摄入时应谨慎使用。

参考文献:Melanie V. Betz, Fredric L. Coe, Arlene B. Chapman, Agreement of Food Records and 24-Hour Urine Studies in Clinical Practice, Journal of Renal Nutrition, Volume 32, Issue 1, 2022, Pages 51-57, ISSN 1051-2276, https://doi.org/10.1053/j.jrn.2021.07.005.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1725317, encodeId=541f1e253172d, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Sun Mar 13 06:42:00 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1717691, encodeId=a8271e176917f, content=<a href='/topic/show?id=a7ab15318fc' target=_blank style='color:#2F92EE;'>#renal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15318, encryptionId=a7ab15318fc, topicName=renal)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28bc32453681, createdName=jml2020, createdTime=Mon May 30 20:42:00 CST 2022, time=2022-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324486, encodeId=f02e1324486e4, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416927, encodeId=0ac4141692e3f, content=<a href='/topic/show?id=27c710101804' target=_blank style='color:#2F92EE;'>#食物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101018, encryptionId=27c710101804, topicName=食物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3a33221853, createdName=yhy100201, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449417, encodeId=333f144941ea0, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-03-13 chengjn
  2. [GetPortalCommentsPageByObjectIdResponse(id=1725317, encodeId=541f1e253172d, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Sun Mar 13 06:42:00 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1717691, encodeId=a8271e176917f, content=<a href='/topic/show?id=a7ab15318fc' target=_blank style='color:#2F92EE;'>#renal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15318, encryptionId=a7ab15318fc, topicName=renal)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28bc32453681, createdName=jml2020, createdTime=Mon May 30 20:42:00 CST 2022, time=2022-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324486, encodeId=f02e1324486e4, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416927, encodeId=0ac4141692e3f, content=<a href='/topic/show?id=27c710101804' target=_blank style='color:#2F92EE;'>#食物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101018, encryptionId=27c710101804, topicName=食物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3a33221853, createdName=yhy100201, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449417, encodeId=333f144941ea0, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-05-30 jml2020
  3. [GetPortalCommentsPageByObjectIdResponse(id=1725317, encodeId=541f1e253172d, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Sun Mar 13 06:42:00 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1717691, encodeId=a8271e176917f, content=<a href='/topic/show?id=a7ab15318fc' target=_blank style='color:#2F92EE;'>#renal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15318, encryptionId=a7ab15318fc, topicName=renal)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28bc32453681, createdName=jml2020, createdTime=Mon May 30 20:42:00 CST 2022, time=2022-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324486, encodeId=f02e1324486e4, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416927, encodeId=0ac4141692e3f, content=<a href='/topic/show?id=27c710101804' target=_blank style='color:#2F92EE;'>#食物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101018, encryptionId=27c710101804, topicName=食物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3a33221853, createdName=yhy100201, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449417, encodeId=333f144941ea0, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1725317, encodeId=541f1e253172d, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Sun Mar 13 06:42:00 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1717691, encodeId=a8271e176917f, content=<a href='/topic/show?id=a7ab15318fc' target=_blank style='color:#2F92EE;'>#renal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15318, encryptionId=a7ab15318fc, topicName=renal)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28bc32453681, createdName=jml2020, createdTime=Mon May 30 20:42:00 CST 2022, time=2022-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324486, encodeId=f02e1324486e4, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416927, encodeId=0ac4141692e3f, content=<a href='/topic/show?id=27c710101804' target=_blank style='color:#2F92EE;'>#食物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101018, encryptionId=27c710101804, topicName=食物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3a33221853, createdName=yhy100201, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449417, encodeId=333f144941ea0, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]
    2022-03-11 yhy100201
  5. [GetPortalCommentsPageByObjectIdResponse(id=1725317, encodeId=541f1e253172d, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Sun Mar 13 06:42:00 CST 2022, time=2022-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1717691, encodeId=a8271e176917f, content=<a href='/topic/show?id=a7ab15318fc' target=_blank style='color:#2F92EE;'>#renal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15318, encryptionId=a7ab15318fc, topicName=renal)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=28bc32453681, createdName=jml2020, createdTime=Mon May 30 20:42:00 CST 2022, time=2022-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324486, encodeId=f02e1324486e4, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416927, encodeId=0ac4141692e3f, content=<a href='/topic/show?id=27c710101804' target=_blank style='color:#2F92EE;'>#食物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101018, encryptionId=27c710101804, topicName=食物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3a33221853, createdName=yhy100201, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449417, encodeId=333f144941ea0, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66095470791, createdName=zhaohui6733, createdTime=Fri Mar 11 06:42:00 CST 2022, time=2022-03-11, status=1, ipAttribution=)]