Hemodiyaliz Hastalarında Diyet Asit Yükü (DAL) ile Kardiyovasküler Risk Etmenleri Arasındaki İlişki: Pilot Çalışma

Amaç: Yüksek sülfür içeren proteinli, düşük sebze ve meyve içeren diyetler vücut asit baz dengesini etkilemekte ve bu diyetler kronik böbrek yetmezliği hastalığının seyrini olumsuz bir biçimde etkileyebilmektedir. Hemodiyaliz (HD) hastalarında kardiyovasküler risk etmenleri üzerinde diyetin potansiyel etkisi konsunda az bilgi bulunmaktadır. Çalışmanın amacı HD hastalarının kardiyovasküler hastalık risk etmenleri ile diyet asit yükü arasındaki ilişkiyi değerlendirmektir. Bireyler ve Yöntem: En az bir yıldır düzenli HD tedavisi alan 23 erkek, 17 kadın olmak üzere toplam gönüllü 40 hasta (53.8±8.20 yıl) çalışmaya alınmıştır. Hastaların genel özellikleri anket tekniğiyle öğrenilmiştir. Besin tüketimleri bir diyaliz günü-iki diyaliz dışı gün olmak üzere "besin tüketim kayıt" yöntemiyle alınmış ve endojen asit üretiminin tahminini sağlayan diyet asit yükü (DAL), PRAL ve NEAP yöntemi kullanılarak hesaplanmıştır. Hastaların rutinde alınan kan örneklerinin sonuçları diyaliz merkezinin kayıtlarındaki bilgisayar ortamından alınmıştır. Diyet alımı ile ilgili risklerin belirlenmesinde Amerika Kalp Birliği, Ulusal Böbrek Vakfı ve Avrupa Klinik Nütrisyon ve Metabolizma Derneği önerileri kullanılmıştır. PRAL düzeylerinin besin ögeleri ve besin gruplarıyla olan ilişkisinin incelenmesinde çoklu regresyon analizi, PRAL'a etki edebilecek bağımsız değişkenlerin risk ölçütü Binary Logistic Regression yöntemi kullanılarak hesaplanmıştır. Bulgular: Çalışmaya katılan hastaların PRAL ortalaması erkeklerde (14.5±15.48 mEq/gün) kadınlardan (12.7±7.09 mEq/gün) daha yüksek iken (p0.05). Risk etmenlerinden diabetes mellitusu (16.6±18.88 mEq/gün) olan, sigara kullanan (19.5±21.54 mEq/gün) ve serum kalsiyum düzeyi 10.2 mmol/L'nin üzerinde olan (15.9±24.74 mEq/gün) hastaların PRAL ortalamaları arasındaki fark istatistiksel açıdan önemlidir (p

Association of Dietary Acid Load (DAL) and Cardiovascular Risk Factors in Hemodialysis Patient: The Pilot Study

Aim: Diets high in sulfur-rich protein and low fruits and vegetables affect human acid-base balance adversely and can have a harmful effect on progression of chronic kidney disease (CKD). Little is known about the potential influence of diet on cardiovascular risk factors in hemodialysis patients. This study examined the association of dietary acid load with cardiovascular risk factors in hemodialysis patients. Subject and Methods: The present study includes 23 male and 17 female with a total of 40 HD patients (53.8±8.20 year) including undergoing maintenance hemodialysis for more than 1 years. General characteristics of the patients were found with the survey method. Food consumption including a dialysis day and two non-dialysis days were taken with “food consumption record” method and dietary acid load (DAL) that enables the prediction of endogenous acid production was calculated using the PRAL and NEAP method. The results of blood samples in routine were taken from computer records of the dialysis center. Multiple regression analysis to examine the relationship between nutrients and food groups with PRAL levels; risk measure of the independent variables that may affect the PRAL was calculated using Binary Logistic Regression method. Results: While PRAL average of the patients in the study for males (14.5±15.48 mEq/day) was higher than females (12.7±7.09 mEq/day) (p

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