magistrsko delo
Maša Škrlep (Author), Lea Pogačnik (Reviewer), Bojan Knap (Mentor)

Abstract

Evalvacija prehranskega vnosa pri bolnikih na peritonealni dializi je nujna za razumevanje povišanih vrednosti serumskih fosfatov, pa tudi za monitoring beljakovinskega vnosa, ki je zaradi predpisane restrikcije fosfatov glede na smernice praviloma prenizek. 20 bolnikov na peritonealni dializi je bilo naključno izbranih in analiziranih z namenom ugotoviti, kakšen je njihov energijski in hranilni vnos, s poudarkom na beljakovinah in fosfatih. S prehranskim intervjujem smo v obdobju treh mesecev trikrat izvedli metodo priklica jedilnika prejšnjega dne (24-urni priklic) in ga analizirali s spletnim orodjem OPKP. Sestava telesa je bila izmerjena z bioimpendančno spektroskopijo, opravljena je bila tudi biokemijska preiskava krvi. Povprečni energijski vnos 20 bolnikov, z upoštevnim energijskim doprinosom iz dializata, znaša (25,6 ± 6,7) kcal/kg TM/dan, povprečni beljakovinski vnos pa (0,9 ± 0,3) g/kg TM/dan. Glede na priporočila sta prenizka, možno je podcenjeno poročanje bolnikov v prehranskem intervjuju. Povprečni vnos mikrohranil (K, P, Na in Ca) je v referenčnem območju, primernem za dializne bolnike, kar je presenetljivo glede na visoke vrednosti serumskih fosfatov ((1,6 ± 0,4) mmol/L) in intaktnega paratiroidnega hormona ((450 ± 393) ng/L), kar nakazuje na hiperfosfatemijo in sekundarni hiperparatiroidizem. Korelacije med prehranskim vnosom fosfatov in serumskimi fosfati statistično značilno (p = 0,509) nismo zaznali, obstaja pa povezava med vnosom fosfatov in energijskim vnosom (p = 0,0001). Analiza poročanih fosfatov je pokazala, da so bolniki zaužili 60 % beljakovin živalskega izvora in 40 % beljakovin rastlinskega izvora, razmerje med beljakovinami in fosfati je bilo (16 ± 3,6). Anorganski fosfati iz fosfatnih aditivov niso bili zaznani zaradi odsotnosti podatkov v prehranski podatkovni bazi.

Keywords

prehrana;kronična ledvična bolezen;dializni bolniki;peritonealna dializa;vnos fosfatov;hiperfosfatemija;sekundarni hiperparatiroidizem;metoda jedilnika prejšnjega dne;

Data

Language: Slovenian
Year of publishing:
Typology: 2.09 - Master's Thesis
Organization: UL BF - Biotechnical Faculty
Publisher: [M. Škrlep]
UDC: 613.2:616.61
COBISS: 42866691 Link will open in a new window
Views: 453
Downloads: 81
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Other data

Secondary language: English
Secondary title: Analysis of phosphate intake in dialysis patients
Secondary abstract: Evaluation of the dietary intake in patients on peritoneal dialysis is necessary for understanding of elevated phosphorus levels, as well as protein intake monitoring, which struggles to meet current dietary guidelines. 20 patients on peritoneal dialysis were randomly selected in Dialysis Centre of University Clinical Centre of Ljubljana, with the purpose to detect energy and nutritional intake, especially protein and phosphorus intake. A food propensity questionnaire has been carried out with three unannounced 24-hour dietary recalls per participant through a web-based application “OPEN” and picture book in three months period. Body composition was measured with bio-impedance spectroscopy and biochemical blood tests were performed. Average caloric intake of 20 patients was (25,6 ± 6,7) kcal/kg of body weight per day, dialysate included; average protein intake was (0,9 ± 0,3) g/kg body weight per day. They were inadequate according to the dietary recommendations for dialysis patients on peritoneal dialysis. Average intake of analysed micro-nutrients (K, P, Na) corresponds to the recommendations for dialysis patients which is surprising according to high levels of serum phosphorus (1,6 ± 0,4 mmol/L) and intact parathyroid hormone ((450 ± 393) ng/L). These levels are associated with hyperphosphatemia and secondary hyperparathyroidism. Phosphorus intake was moderately to strongly correlated with the dietary energy intake (p = 0,0001). The correlation between dietary phosphorus intake and serum phosphorus was insignificant (p = 0,509). According to the dietary report, the intake of protein was 60% animal and 40% plant. The ratio of protein intake versus dietary phosphorus was (16 ± 3,6). Inorganic phosphates from additives were not detected due to a lack of information in the database.
Secondary keywords: nutrition;chronic kidney disease;dialysis patients;peritoneal dialysis;phosphate dietary intake;hyperphosphatemia;secondary hyperparatiroidism;24 hour recall;
Type (COBISS): Master's thesis/paper
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Univ. v Ljubljani, Biotehniška fak., Oddelek za živilstvo
Pages: XI, 67 str.
ID: 12267568