Title Utjecaj nutritivne intervencije tijekom hemodijaliznog postupka na nutritivni status tijekom COVID-19 pandemije
Title (english) The effect of nutritional intervention during a hemodialysis procedure on nutritional status during a COVID-19 pandemic
Author Lucija Šolić
Mentor Josipa Radić (mentor)
Committee member Duška Glavaš (predsjednik povjerenstva)
Committee member Joško Božić (član povjerenstva)
Committee member Marino Vilović (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2021, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract Ciljevi: Cilj navedenog istraživanja je bio istražiti da li je ukidanje obroka tijekom HD postupka dovelo do značajnih promjena u pokazateljima nutritivnog statusa bolesnika liječenih postupcima kronične HD.
Postupci i ispitanici: U istraživanje je uključeno ukupno 55 bolesnika, 33 muškaraca i 22 žene liječenih kroničnom HD tijekom analiziranih intervala (ožujak 2019. , ožujak 2020. te ožujak 2021. godine). Podatci o dobi, spolu, postojanju arterijske hipertenzije, šećerne bolesti, amputaciji udova te duljini liječenja HD prikupljeni su iz dostupne medicinske dokumentacije. Prikupljeni su i podaci o tjelesnoj visini i tjelesnoj težini u ožujku za svaki promatrani period. Također, za svakog ispitanika su prikupljeni podaci o broju hipotenzivnih epizoda tijekom HD postupka te podatci o vrijednostima SAT, DAT, MAP i PP na početku HD u promatranim mjesecima. Iz dostupne medicinske dokumentacije prikupljene su vrijednosti laboratorijskih parametara koji predstavljaju pokazatelje nutritivnog statusa za sva tri promatrana vremenska intervala. Prikupljeni su rezultati DMS upitnika tijekom promatranog mjeseca u svakom od navedenih razdoblja.
Rezultati: Godinu dana nakon ukidanja obroka tijekom HD postupka bilježi se značajni porast vrijednosti MCV-a te značajno snižavanje vrijednosti ukupnog kolesterola i ITM. Godinu dana nakon ukidanja obroka tijekom HD bilježi se statistički značajno manje hipotenzivnih epizoda tijekom postupka HD. Vrijednost PTH je značajni prediktor za nastanak hipotenzivnih epizoda tijekom HD postupka godinu dana nakon izostavljanja obroka tijekom HD. Godinu dana nakon ukidanja obroka tijekom HD nije zabilježeno statistički značajno manje hipotenzivnih epizoda tijekom postupka HD u bolesnika ≤ 65 godina života, dok je kod bolesnika > 65 godina zabilježeno statistički značajno manje hipotenzivnih epizoda.
Zaključci: Nutritivna intervencija tj. ukidanje obroka tijekom HD postupka imala negativan utjecaj na nutritivni status ove populacije bolesnika tijekom jednogodišnjeg praćenja. Uz navedene negativne učinke, ova nutritivna intervencija je imala i pozitivan učinak tijekom praćenja tj. značajno smanjenje broja hipotenzivnih epizoda tijekom HD postupka bez utjecaja na dozu HD. Također, rezultati su ukazali kako su HD bolesnici ≤ 65 godina posebno vulnerabilna skupina.
Abstract (english) Objectives: The main objective of this study was to investigate whether the omission of a meal during the HD procedure led to significant changes in the indicators of nutritional status of patients treated with chronic HD procedure.
Subjects and procedures: The study included a total of 55 patients, 33 men and 22 women treated for chronic HD during the analyzed intervals (March 2019, March 2020 and March 2021). Data on age, sex, hypertension, diabetes, limb amputation, and length of HD treatment were collected from available medical records. Data on body height and body weight in March for each observed period were also collected. Also, data on the number of hypotensive episodes during the HD procedure and data on the values of SAT, DAT, MAP and PP at the beginning of HD in the observed months were collected for each subject. From the available medical documentation, values of laboratory parameters were collected, which represent indicators of nutritional status for all three observed time intervals. The results of the DMS questionnaire were collected during the observed month in each of the mentioned periods.
Results: One year after the omission of meals during the HD procedure, there was a significant increase in MCV and a significant decrease in total cholesterol and BMI. One year after the abolition of meals during HD, there were statistically significantly fewer hypotensive episodes during the HD procedure. A PTH value is a significant predictor of the occurrence of hypotensive episodes during the HD procedure one year after meal omission during the HD. One year after meal withdrawal during HD, no statistically significantly fewer hypotensive episodes were reported during the HD procedure in patients ≤ 65 years of age, while statistically significantly fewer hypotensive episodes were reported in patients> 65 years of age.
Conclusions: Nutritional intervention (omission) of meals during the HD procedure, had a negative impact on the nutritional status of this patient population during one-year follow-up. In addition to the above negative effects, this nutritional intervention also had a positive effect during follow-up, ie a significant reduction in the number of hypotensive episodes during the HD procedure without affecting the HD dose. Also, the results indicated that HD patients ≤ 65 years of age are a particularly vulnerable group.
Keywords
Kronična bubrežna insuficijencija
Bubrežna dijaliza
COVID-19
Nutritivni status
Proteinsko-energetska pothranjenost
Keywords (english)
Renal Insufficiency Chronic
Renal Dialysis
COVID-19
Nutritional Status
Protein-Energy Malnutrition
Language croatian
URN:NBN urn:nbn:hr:171:982906
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
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File origin Born digital
Access conditions Open access Embargo expiration date: 2023-07-27
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Created on 2021-07-29 12:10:53