慢性肾脏病随访患者的饮食依从性调查

Investigation on Dietary Compliance of Patients with Chronic Kidney Disease during Follow-Up

摘要: 目的：调查接受过饮食指导的慢性肾脏病(CKD)随访患者的饮食依从性，为更好的开展CKD饮食管理工作提供依据。方法：针对北京大学第一医院肾内科随访门诊的患者，给予肾病饮食指导。能提供三天饮食记录者，按推荐的主食类别分组进行饮食依从性分析；不能记录饮食者仅进行问卷调查。使用描述性统计、配对样本t检验、单因素ANOVA分析等方法进行统计分析。结果：患者总数190人，男127人，女63人，全部来自北京大学第一医院肾内科随访门诊，其中53人按照使用主食类别分组纳入饮食依从性分析，137人仅进行饮食问卷调查。饮食依从性结果显示：低蛋白主食组、薯类组和低蛋白主食 + 薯类组患者的热量摄入显著低于普通主食组(F = 4.100, P = 0.011)。普通主食组实际DPI (1.081 ± 0.254 g/kg/d)显著高于推荐DPI (0.891 ± 0.094 g/kg/d) (t = −2.247, P = 0.048)；低蛋白组的实际DEI (23.618 ± 4.195 kcal/kg/d)显著低于推荐DEI (26.571 ± 1.599 kcal/kg/d) (t = 3.240, P = 0.004)；薯类组的实际DEI (23.208 ± 4.043 kcal/kg/d)显著低于推荐DEI (26.000 ± 0.961 kcal/kg/d) (t = 2.802, P = 0.015)；低蛋白 + 薯类组的实际DEI (23.043 ± 3.900 kcal/kg/d)显著低于推荐DEI (28.429 ± 1.618 kcal/kg/d) (t = 4.041, P = 0.007)。问卷调查显示低盐饮食是影响患者依从性的首要因素。结论：CKD患者的饮食依从性不佳，需要加强对CKD患者的饮食管理。

Abstract: Objective: To investigate the dietary compliance of follow-up patients with chronic kidney disease (CKD) who received dietary guidance, so as to provide evidence for better dietary management of CKD. Methods: Dietary guidance was given to patients in the follow-up clinic of Nephrology De-partment of Peking University First Hospital, who could provide three-day dietary records, and dietary compliance was analyzed according to the recommended staple food categories. Those who could not record their diet were only questionnaires. Descriptive statistics, paired sample t test and ANOVA analysis were used for statistical analysis. Results: The total number of patients was 190, 127 males and 63 females. All of them came from the follow-up clinic of Renal Medicine Department of the First Hospital of Peking University. 53 of them were grouped into dietary compliance analysis according to the type of staple food used. 137 of them only conducted dietary questionnaires. The results of dietary compliance showed that the calorie intake of low protein staple food group, potato group and low protein staple food + potato group was significantly lower than that of common staple food group (F = 4.100, P = 0.011). The actual DPI (1.081 ± 0.254 g/kg/d) of the common staple food group was significantly higher than the recommended DPI (0.891 ± 0.094 g/kg/d) (t = −2.247, P = 0.048); the actual DEI (23.618 ± 4.195 kcal/kg/kg/d) of low protein group was significantly lower than the recommended DEI (26.571 ± 1.599 kcal/kg/d) (t = 3.240, P = 0.004). The actual DEI (23.208 ± 4.043 kcal/kg/d) of potato group was significantly lower than the recommended DEI (26.000 ± 0.961 kcal/kg/d) (t = 2.802, P = 0.015); the actual DEI (23.043 ± 3.900 kcal/kg/d) of the low protein + potato group was significantly lower than the recommended DEI (28.429 ± 1.618 kcal/kg/d) (t = 4.041, P = 0.007). Questionnaire survey showed that low salt diet was the primary factor affecting patient compliance. Conclusion: The dietary compliance of CKD patients is not good. It is necessary to strengthen the dietary management of CKD patients.