Purpose

Nutritional status and micronutrient levels of end stage renal disease (ESRD) patients may vary depending on the mode of renal replacement therapy (RRT). We aimed to compare the effects of hemodialysis, peritoneal dialysis (PD) and renal transplantation (RT) on micronutrient levels and nutritional status in ESRD patients.

Patients and Methods

A total of 77 ESRD patients who had not received RRT were included in this prospective longitudinal study. All ESRD patients underwent a blood serum analysis that assessed the micronutrients such as selenium, copper, zinc, chromium, retinol, thiamine and vitamin B6 as well as a nutritional status assessment. After the baseline assessments and the initiation of RRT was accomplished, all patients were followed for 6 months.

Results

The study showed significant improvements in subjective global assessment scores (percentage increases in score A were 26.6 and 36.6; p = 0.039 and p = 0.001; respectively), mid-arm circumference and the skin-fold thicknesses (p < 0.001, p < 0.001; respectively) in the RT and hemodialysis groups. The examinations at sixth month revealed a significant increase in body weight (4.8 kg; p = 0.002) and albumin levels (0.6 g/dL; p < 0.001) in only RT group. Zinc, thiamin and vitamin B6 were the most deficient micronutrients (44.1%, 24.7% and 35.1%; respectively) in ESRD patients. There was a significant increase in selenium and retinol levels (p = 0.020 and p < 0.001; respectively) but a significant decrease in thiamin levels (p = 0.041) in RT patients. A significant increase in retinol levels (p = 0.028) and a significant decrease in thiamin levels (p = 0.022) was observed in the hemodialysis patients. However, no significant change in micronutrient levels was observed in the PD patients.

Conclusion

The results support the recommendation that ESRD patients should be supplemented with water-soluble vitamins, especially thiamine and vitamin B6, and trace elements, especially zinc. RT appears to be superior to other modes of RRT when examining SGA score, anthropometric measurements, albumin and micronutrient levels.

中文翻译：

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血液透析，腹膜透析和肾脏移植对终末期肾脏疾病患者营养状况和血清微量营养素水平的影响；多中心，六个月，纵向研究

目的

终末期肾病（ESRD）患者的营养状况和微量营养素水平可能会因肾脏替代疗法（RRT）的模式而异。我们旨在比较血液透析，腹膜透析（PD）和肾移植（RT）对ESRD患者微量营养素水平和营养状况的影响。

患者和方法

该前瞻性纵向研究共纳入了77例未接受RRT的ESRD患者。所有ESRD患者均接受了血清分析，评估了微量营养素，如硒，铜，锌，铬，视黄醇，硫胺素和维生素B6以及营养状况评估。在完成基线评估并完成RRT的启动后，所有患者均接受了6个月的随访。

结果

该研究表明，主观整体评估得分（A分数分别增加26.6和36.6； p = 0.039和p = 0.001；），手臂中围和皮褶厚度（p <0.001，p <0.001）有显着改善。 ；分别）在RT和血液透析组中。第六个月的检查显示，仅RT组的体重（4.8 kg； p = 0.002）和白蛋白水平（0.6 g / dL； p <0.001）显着增加。锌，硫胺素和维生素B6是ESRD患者中最缺乏的微量营养素（分别为44.1％，24.7％和35.1％）。RT患者的硒和视黄醇水平显着增加（分别为p = 0.020和p <0.001；但硫胺素水平显着下降（p = 0.041））。视黄醇水平显着增加（p = 0。028），并且在血液透析患者中​​观察到硫胺素水平显着降低（p = 0.022）。然而，在PD患者中未观察到微量营养素水平的显着变化。

结论

结果支持建议ESRD患者应补充水溶性维生素（尤其是硫胺素和维生素B6）和微量元素（尤其是锌）。在检查SGA评分，人体测量，白蛋白和微量营养素水平时，RT似乎优于其他RRT模式。