Hemodiyaliz Tedavisi Alan Hastaların Beslenme Durumlarının Değerlendirilmesinde Biyoempedans Yöntemi Yeterli Midir?

Öz

Amaç: Bu çalışmada amaç, biyoempedans analiz (BIA) yönteminin hemodiyaliz tedavisi alan hastaların beslenme durumlarının değerlendirilmesinde güvenilirliğinin test edilmesidir. Yöntem: Kesitsel tipteki bu çalışma, iki devlet hastanesi ve bir özel hemodiyaliz merkezinde hemodiyaliz tedavisi alan 166 hasta ile yürütüldü. Araştırmada veriler, hasta tanıtım formu, Malnutrisyon Inflamasyon Skoru (MIS) ve biyoempedans temeline dayalı Çoklu Vucüt Analiz Cihazı ile toplandı. Verilerin değerlendirilmesinde tanımlayıcı istatistiksel analizler, t testi, Mann-Whitney U, ki kare, Wilcoxon, ROC analizi ve ikili logistik regresyon analizleri yapıldı. Bulgular: Araştırmaya katılan hastaların yaş ortalaması 51,57±13,01 (21-66) yıl olup büyük çoğunluğu (%53,6) erkek idi. Hastalarının beden kütle indeksi (BKI) ortalaması 24,4 kg/m2 olup %54,8’nin beslenme durumunun iyi olduğu belirlendi. Erkek hastaların albümin, kas kütlesi ve BKI’leri kadın hastalardan daha yüksek bulundu. Beslenme durumu iyi olan hastalar ile malnutre olan hastalar arasında hemoglobin, albümin, demir bağlama, tanita yağ yüzdesi, tanita yağ kütlesi, tanita kas kütlesi ve beden kütle indeksi ölçümleri açısından istatistiksel olarak anlamlı fark olduğu belirlendi (p˂0,05). Sonuç: MIS değerleri ile BIA ölçüm parametreleri arasında yapılan logistik regresyon analizi sonucunda tanı testi performansı istatistiksel olarak anlamlı bulundu. Araştırma sonuçları BİA parametrelerinin malnutrisyonu öngörmede tanısal karar verdirici olduğunu gösterdi. Buna göre; BIA yönteminin hemodiyaliz tedavisi alan hastalarda beslenme durumlarının değerlendirilmesinde kullanılması önerilebilir.

Anahtar Kelimeler

• Beslenme durumu
• malnutrisyon
• beslenme değerlendirmesi

Is the Bioimpedance Method Sufficient in Evaluating the Nutritional Status of Patients Receiving Hemodialysis Treatment?

Öz

Aim: The purpose of this study was to test validity of bioelectrical impedance (BIA) analysis in the nutritional assessment among patients with receiving hemodialysis. Method: This study which was cross-sectional was conducted with 166 patients with hemodialysis at the hemodialysis units in two state hospital and a private hospital. The data were collected by means of patient information form, Malnutrition Inflammation Score (MIS) and Body Composition Analyzer. Descriptive, t test, Mann-Whitney U, chi-square, Wilcoxon, ROC analysis and logistic regresyon analysis were used in statistical analysis. Results: The average ages of patients were 51.57±13.01 (21-66) years. Of the patients, 53.6% were male. Mean body mass index (BMI) was 24.4±4.98 kg/m2 of whom (%54.8) were well-nourished. Male patients had higher albumin, muscule mass, and BMI than female patients and these values were statistical difference in according to gender. A significant difference was found to hemoglobin, albümin, iron binding, tanita fat ratio, fat mass, and BMI between the well-nourished and malnourished patients. The findings of logistic regretion analysis among MIS and BIA parameters shown that performance of BIA was statistical significantly. Conclusion: The results of study indicated that bioelectrical impedance analysis was shown to identify the most suitable BIA parameters for predicting presence of malnutrition. It could be suggested that BIA method may use for assess to nutritional status among patients receiving hemodialysis.

Anahtar Kelimeler

• Nutritional status
• malnutrition
• nutrition assessment

Kaynakça

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