İBRAHİM GÜNEY, Lütfullah ALTINTEPE, NİLSEL OKUDAN, H. Zeki TONBUL, Süleyman TÜRK, Mehdi YEKSAN

Amino asitli diyalizatların malnütrisyonlu SAPD hastalarında nütrisyonel ve diğer laboratuar parametreleri üzerine 1 yıllık dönemdeki etkileri

Amaç: Malnütrisyon periton diyaliz hastalarında ciddi bir problemdir ve morbitide-mortalitenin önemli nedenlerindendir. Amino asit içeren peritoneal diyaliz solüsyonları (nutrineal) ile diyaliz yapılan malnütrisyonlu hastalarda nutrisyonel durum ve diğer laboratuar parametrelerindeki değişiklikleri incelemeyi amaçladık. Yöntem: Serum albumin düzeyi ≤ 3.5 g/dl olan 19 SAPD hastası çalışmaya alındı. Hastaların bir yıllık takiplerinde; 5 hastanın exitus, 2 hastanın hemodiyalize ve bir hastanın ise APD’ye transfer olması, 2 hastada karın ağrısı, 1 hastada ise bulantı-kusma gelişmesi nedeni ile çalışmadan çıkarıldı. Çalışmayı tamamlayan 8 hastanın (6E/2K), yaş ortalaması 49.5±11.1 yıl idi. Başlangıç ve 1. yılda serum üre, kreatinin, total protein, albumin, ürik asid, fosfor, total kolesterol, trigliserid, hemoglobin düzeyleri, triseps deri kıvrım kalınlığı (TST), vücut yağ oranı ve vücut kitle indeksi (VKİ) belirlendi. Bulgular: Bir yıllık takip sonrasında ise başlangıç değerlerine göre serum albumin (p=0.035), üre (p=0.002) değerlerinde ve VKİ’de (p=0.011) anlamlı artış saptanırken, ürik asit (p=0.009) ve trigliserid (p=0.004) değerlerinde anlamlı bir düşüş saptandı; diğer parametrelerde ise anlamlı bir fark saptanmadı. Sonuç: Amino asitli diyaliz solüsyonlarının malnütrisyonu bulunan SAPD hastalarında malnütrisyonu düzeltmek için kullanılabileceği kanaatindeyiz.

Effects of amino acid dialysis solution on the nutritional and other laboratory parameters in the malnourished CAPD patients for one year period.

Objective: Malnutrition is a major complication of peritoneal dialysis (PD) patients and it is the most important causes of morbidity and mortality. We investigated changing of the nutritional and other laboratory parameters with using a PD solution containing 1.1% a.a. in CAPD patients. Methods: Nineteen CAPD patients were included to the study, their levels of serum albumin was <3.5 g/dl. Five patients died, 2 patients were transferred to hemodialysis, 1 patient was transferred to APD, abdominal pain was observed in 2 patients and nausea- vomiting was observed in 1 patient during the study period. Mean age was 49.5±11.1 years in eight patients (6M, 2F) that completed the study. Levels of serum urea, creatinin, total protein, albumin, uric acid, phosphorus, total cholesterol, triglyceride, hemoglobin, triceps skin folds, body fat ratio and body mass index (BMI) were assessed at baseline and at 12 month. Results: We found significant increase in serum albumin (p=0,035), urea (p=0,002) and BMI (p=0,011), and significant decrease in serum uric acid (p=0,009), and triglyceride (p=0,004). But there was no significantly difference in other parameters after the following 1 year. Conclusion: A containing a.a. solutions in malnourished CAPD patients may be use for impairing malnutrition.

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