medigraphic.com
ISSN 1561-3186 (Electronic)

2003, Number 1

<< Back Next >>

Rev Acta Médica 2003; 11 (1)

Nutritional and metabolic balances in patients with end-stage renal disease

Roque ML, Santos HCM, Hernández GM

Language: Spanish
References: 20
Page:
PDF size: 110.39 Kb.


ABSTRACT

A prospective investigation of the nutritional and metabolic balances of 8 male patients with End-Stage Renal Disease (ESRD) during dialytic treatment was performed. The patients were exposed during 12 weeks to a dietetic intervention consisting of: 1) recording the consumption of foods and 2) a menu tailored to meet the needs of the patient during the 3 days of dialysis. The diet was planned according with the criteria set forth by both the XV Food Guidelines of the American Association of Nephrology and the FAO/WHO Experts Committee on Proteins. The following variables were measured: serum Albumin, Haemoglobin, Bicarbonate, Ionogram, Creatinine, Urea, Uric acid. The Body Mass Index (BMI) was also calculated, and the diameter of the cava vein was estimated by ultrasonographic means. Data proccessing was performed taking into account the normality of the measured variables, their distributions and means. t-Student test was applied in the case of independent variables, along with stepwise regression analysis for selected variables. Results. The results showed a significant association between Haemoglobin and Albumin on one hand, and nitrogen intake and their changes in the days of dialysis during the intervention period (p ‹ 0.05, t-Student test for independent variables). No patient showed any complication during the period of the study. Intakes of nitrogen, histidine, leucine, isoleucine and methionine were controlled. Conclusions. It is concluded the importance of the use of the diets made from natural foods for the nutritional support of the ESRD patient with an specific catabolic pattern in view of their low cost, feasibility, and capability to increase the metabolic efficiency of the patient.


REFERENCES

  1. Jackson, AA. Critique of protein energy interactions in vivo: urea Kinetics. En: op.cit.6: 67-68, 1992.

  2. Di Cecco SR. Clinical Mayo Procedures Nutritional Therapy and Transplantation 1996:311-357.

  3. Davidson, Stanley. Human Nutrition and Dietetics. 6 ta ed. Edinburgh London and New York, P(173), 1979.

  4. Churchill, DNy cols. Canadian Hemodialysis Morbidity Study. Am J Kidney Dis 1992; 3:241-244.

  5. Colectivo de autores. Am J Kidney Dis 2001;37(1 suppl 2):566-70.

  6. 6. Paz Venegas M. Evaluación Nutricional y requerimientos nutricionales en Hemodializados adultos. Revista medica clínica Las Condes. Vol. 7 N o 3, P: 121 – 125. Diciembre 1996.

  7. National research council. Protein and amino acid. The requirement for amino acids, table 6.1 P(56, 253, 66). Recomended Dietary Allownce, 10 th edition, 1989.

  8. Fresenius. Fórmula de Nefrosteril para 1 Litro. Laboratorios Roux- OCEFA, Montevideo 79 (1019), Buenos Aires. 3/04/98.

  9. Swendseid A, Marian E.. Essential amino acid requiremts. Joint FAO/WHO/UNU Expert Consultation on energy and protein requirements, P(3-10) Rome, october, 1981.

  10. Laidlaw, SA, Kopple JD. Newer concepts of the indispensable amino acids. Am J Clin Nutr 1987;46:593-605.

  11. Milward, DJ, Newsholme EA, Pellet, Pr, UaUy, R. Amino acid scoring in health and disease. En: Protein-Energy Interactions (Editor: Scrimshaw NS, Schurch B). Nestlé Foundation. Lausanne P(405-413), 1992.

  12. May, R.C., Y. Hara, R. A. Kelly, K. P. Block, M. G. Bluse, and W. E. Mitch. Branched-chain amino acid metabolism in rat muscle: abnormal regulation in acidosis. Am J Physiol. 1987;252:E712-E718.

  13. Mandelbaum A, Ritz E. Vena cava diameter measurement for estimation of dry weight in haemodialysis patients. Nephrol Dial Transplant 1996,11.

  14. Kopple JD. Nitrogen metabolism. Clinical aspects of uremia and dialysis. (Editores: Massry N, A.L.Sellers). Springfield. II Charles C. Thomas. 1976.

  15. Kopple JD. National Kidney Foundation NFK/DOQI Clinical Practice Guideline for dietary protein intake for chronic dialysis patients. Am J Kidney Dis 2001;38(4 Suppl): 568-573.

  16. Furst P. Eficaccy of amino acid and synthetic dipeptides for the treatment of clinical disorders. En: Proceedings of the 16 th International Congress of nutrition. “Nutritional sciencie to nutrition practice for better global health”. Canadian Federation of Biological Societies. Ottawa:1997. (Editores: Fitzpatrick DW, Anderson JE, L´Abbé ML) P(315-350), 1998.

  17. Hakim RM, Breyer J y cols. Effects of dose of dialysis on morbidity and mortality. Am J Kidney Dis 1994;23: 661-669.

  18. ILSI. Conocimientos actuales sobre nutrición. 6 ta edición. Washington, DC. OPS. 1990:436-443.

  19. Orr ML, Watt BK. Aminoacid content of foods. Home Economics Research. Report no. 4. US Department of Agriculture. 1996.

  20. Food Processor. Nutrition Analysis software. (version 7.60). ESHA. 2000.




2020     |     www.medigraphic.com