지속성 외래 복막 투석 환자에서 경구 영양 음료 투여에 의한 영양 보충의 효과

Abstract

Protein-calorie malnutrition is common in CAPD patients and is associated with increased morbidity and moitality. To evaluate the effect of an oral nutritional supplement(Greenbia RD, DR. CHUNGS FOOD CO., LTD, Seoul, Korea) providing 800Cal and 24g of protein daily in addition to their usual diet on the nutritional status, we conducted a prospective study in malnourished CAPD patients (N=26). Subjects were randomised into 2 groups' group I(N=15) taking Greenbia RD" for 3 months, group II(N=11) as control. In group I, the data of 12 patients who completed the 3-months study period were analyzed. There were no statistically significant changes in biochemical parameters including total protein, serum albumin, prealbumin, transfemn during the study period in both groups, but IGF-I increased significantly in group I (129.2± 88.8 vs. 174.1± 109.3ng/mL, P<0.05). Total calorie (1349±272 vs. 1720±251CaVday, P<0.05) and protein intake(1.05±0.29 vs. 1.2±40.25g/kg/day, P<0.05) as- sessed by 72-hours dietary recall method increased significantly in group I with oral supplement. Body weight(52.4±8.3 vs. 54.2±8.8kg, P<O.05), body mass index(18.7±1.8 vs. 19.5±2.0kg/m', P<0.05), % body fat(13.2±4.2 vs. 15.4±3.9%, P<0.05), total body mus- cle(16.8±3.7 vs. 18.2±3.3kg, P<0.05), midarm cir- cumference(22.8±2.1 vs. 23.7±2.2cm, P<0.05) and calculated arm muscle area(25.9±7.1 vs. 28.9±6.1 cm, P<0.05) increased significantly in group I after 3 months. Biceps and triceps skinfold thickness tended to increase following oral nutritional supple- ment but there was no statistical significance. Anthropometric parameters remained unchanged in group II. Kt/Vurea, normalized protein catabolic rate and standardized creatinine clearance did not change in both groups. In conclusion, oral nutritional supple- ment in malnourished CAPD patients well tolerated and was effective in improving the anthropometric parameters.