| Background: Recent years the discovery of compound α-ketoacid can improvenutritional status of pre-dialysis chronic kidney disease patients, propose renal functiondecline. But there are few study on maintaining hemodialysis patients.Objective: To evaluate the effect of compound α-ketoacid on nutritional status inmaintenance hemodialysis patients.Methods: Forty HD patients from First affiliated hospital’ s dialysis center of JILINuniversity were divided in two groups, observed for24weeks (2011.9–2012.3). Each grouphas20patients. Two groups were given the same energy (30-35kcal/kg/d), therapy groupwere given protein (0.8g/kg/d) and compound α-ketoacid while control group were givenprotein (1.0-1.2g/kg/d) for24weeks. Fasting blood sample was collected before dialysis andbreakfast in0weeks,8weeks,16weeks,24weeks. Blood routine examination of blood ureanitrogen, creatinine, albumin and prealbumin, serum calcium, serum phosphorus, parathyroidhormone and record the related numerical. All tests were carried out by First affiliated hospital’s testing center of JILIN university. All of the subjects were using the Inbody720body composition analyzer: body fat, body weight, body weight index, body fat percentage,waist and hip fat ratio and assessment of nutritional status. Demographic data of investigatedHD patients showed mean age:52.7±2.98years, mean dialysis vintage:22.15±2.60months,gender:27males and13females.Of the HD patients,17.5%were diabetic. Glomerulonephritis(27.5%), hypertensive nephropathy(10%), gouty nephropathy (5%), interstitial nephritis (5%)and polycystic kidney(7.5%) were the other frequent causes of ESRD. In25%of patients, theprimary cause of ESRD was unknown.Application SPSS19.0statistical software for data analysis.Results: The prealbumin tended to improve from (0.262±0.081)g/L to (0.342±0.043)g/Lin treatment group after24weeks. After treatment for8weeks,16weeks,24weeks beforetreatment had a significant difference (P<0.001). Serum prealbumin increased from(0.229±0.052)g/L to (0.275±0.056) g/L was found in the control group. Two groups werecompared for8weeks,16weeks,24weeks after treatment, the difference was statisticallysignificant (P=0.001). The albumin tended to improve from(32.29±4.91)g/L to(32.29±4.91)g/L in compound α-ketoacid group, serum albumin increased gradually with time.After treatment for8weeks,16weeks,24weeks before treatment had a significantdifference(P<0.001). Serum albumin improved from (34.21±3.33)g/L to (40.11±3.38)g/L in the control group. Two groups were compared for8weeks,16weeks,24weeks aftertreatment, the difference was statistically significant (P<0.05). Ionized calcium gradually risein the treatment group after24weeks, but tended to decrease in the control group.Serumphosphorus tended to decrease in the α-ketoacid group probably as a result of a significantreduction in dietary phosphorus associated to the phosphorus-binding effect of the ketoacids.No change in phosphorus was found in the control group. Serum parathormone decreased inthe treatment group from (158.98±72.67)pg/ml to (105.4±53.40) pg/ml,(P<0.001). Serumparathormone increased significantly only in the control group from (235.14±176.32)pg/ml to(229.74±155.96) pg/ml, it was increased with time.The treatment group LBW by priortreatment (47.27±12.22) kg rose to(51.13±12.84) kg, showed that lean body weight increasedgradually with time. After treatment for8weeks,16weeks,24weeks before treatment had asignificant difference (P<0.001). The control group of lean body weight by before treatment(44.40±8.10)kg, rose to (47.96±7.91)kg after24weeks. Two groups of LBW compared aftertreatment for8weeks,16weeks,24weeks respectively, the difference was statistically significant(P<0.05).Conclusions:Compound α-ketoacid can improve serum albumin and prealbumin inmaintenance hemodialysis patients. Compound α-ketoacid can improve serum calcium and reduce serum phosphate, decrease serum parathormone correct calcium-phosphatemetabolism, effectively relief hyperparathyroidism in maintenance hemodialysis patients.Compound α-ketoacid can improve Lean body mass in maintenance hemodialysis patients．... |
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