• Title/Summary/Keyword: protein-calorie malnutrition

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A study on Nutritional status and Support in Critically ill patients (서울시내 1 개병원 중환자의 영양상태와 영양지원 실태에 관한 연구)

  • Choe, Mi-Suk;Kim, Jeong-Nam
    • Journal of the Korean Dietetic Association
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    • v.1 no.1
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    • pp.21-30
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    • 1995
  • Critically ill patients admitted in ICU and NCU were studied with respect to their nutritional status and support to them at initial period, and the effect of nutritional support after 3 weeks. The nutritional support was supplied to these patients with the enteral and parenteral nutrition. The results of biochemical test and status of nutritional support on 52(29 males, 23 females) critically ill patients were based on medical records and the anthropometry was measured on 28 patients. The subjects were in mild malnutrition. Their initial calorie intakes were 85% of BEE, 57% of total energy requirements and 49% of protein requirement were provided. Two groups, one group of serum albumin level more than 3.5g/dl and the other group of serum albumin level less than 3.5g/dl, were significant different in total calorie and protein intakes. After 3 weeks, inappropriate nutritional support in the group of normal nutrition results in significant decreasing of serum albumin level but, there were no changes in the group of malnutrition. Nutritional support is one of the mainstays in the management of these critically ill patients and is aimed at preventing malnutrition. Therefore, timely nutritional support is heavily required in cases of critically ill patients whether their initial nutritional status is normal or not.

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A Nurition Survey of the Latter Half of Pregnancy in Nam-Hae Do (남해도 지역이 임신후반기 임부의 영양실태 조사)

  • 이귀세라
    • Journal of the Korean Home Economics Association
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    • v.20 no.3
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    • pp.35-43
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    • 1982
  • The purpose of this survey was to investigate the nutrient and food intake and haematology of the latter half of pregnant women in Nam Hae Do. The nutrient intake study was performed by Twenty-four hour dietary recall method. As Haematology, RBC, Hb. and Hct were measured. 1. The results of nutritional survey were, 1) The mean nutrient intakes that were below the RDA were Protein, Calorie, Calcium and Iron. 2) The mean nutrient intakes that were above the RDA were Vitamin A, Thiamin, Riboflavin, Ascorbic acid. 3) Most of calorie and other nutrients were obtained from vegetable food sources. 4) Animal protein intake was 33% of total protein intake and most of this value was obtained from fish and shell fishes. 2. The extent of malnutrition was explained in terms of the amount of calorie, protein, calcium and iron. The results were, The predicted percentage of deficiency, in case of Calorie, 53.3% of total subjects. in case of Protein, 52% of total subjects. in case of Calcium, 78.7% of total subjects. in case of Iron, 54.7% of total subjects. 3. The results of Haematology were, 1) The mean level of RBC, Hb and Hct were 3.76$\times$106cm/㎣, 10.47gm%, and 32.56% 2) There were significant correlation between calorie intake and Hct level, protein intake and RBC level, Iron intake and MCHC level.

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Comparison of Nutritional Status and Inflammational Markers in DM and nonDM Hemodialysis Patients (당뇨와 비당뇨 유지 혈액투석 환자의 영양상태와 염증지표의 상관성 비교)

  • Kim, Su-An;Sohn, Cheong-Min;Chae, Dong-Wan
    • Korean Journal of Community Nutrition
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    • v.10 no.5
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    • pp.693-699
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    • 2005
  • Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes $(3.45\pm0.43g/dL)$ than in non-diabetic patients $(3.64\pm0.36 g/dL)$ (p<0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes $(1.42\pm1.8mg/dL)$ (p<0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r=-0.553, p<0.01) and non-diabetic (r=-0.579, p<0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r=0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) $(153.1\pm80.1mg/dL\;vs\;101.6\pm62.4mg/dL)$ and decreased serum HDL cholesterol $(36.89\pm13.48mg/dL\;vs\;47.00\pm14.02mg/dL,\;P<0.05)$. There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r=0.438, p< 0.05) and non-diabetic (r=0.527, p<0.05) patients. Serum CRP level was negatively correlated with calorie (r= -0.468, p < 0.05), protein (r=-0.520, p < 0.01) and fat intakes (r=-0.403, p < 0.05) in diabetic patients and calorie (r=-0.534, p<0.05) and protein intakes (r=-0.559, p<0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.

The Calorie and Protein Intake of Critically Ill Patients Who Require Continuous Renal Replacement Therapy in the Intensive Care Unit (중환자실에서 지속성 신대체요법을 받은 신부전 환자의 칼로리와 단백질 공급 현황)

  • Lee, Ho-Sun;Park, Moo-Suk;Na, Sung-Won;Lee, Jae-Gil;Yoo, Tae-Hyun;Koh, Shin-Ok
    • Journal of the Korean Dietetic Association
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    • v.15 no.4
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    • pp.335-342
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    • 2009
  • Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

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Pharmacokinetic Changes in Drugs during Protein-Calorie Malnutrition: Correlation between Drug Metabolism and Hepatic Microsomal Cytochrome P450 Isozymes

  • Lee, Joo-Hyun;Suh, Ok-Kyung;Lee, Myung-Gull
    • Archives of Pharmacal Research
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    • v.27 no.7
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    • pp.693-712
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    • 2004
  • The rats with protein-calorie malnutrition (PCM, 5% casein diet for a period of 4-week) were reported to exhibit 60 and 80% suppression in the hepatic microsomal cytochrome P450 (CYP) 1 A2 and CYP2C11 levels, respectively, and 40-50% decreases in CYP2E1 and CYP3A 1/2 levels compared to control (23% casein diet for a period of 4-week) based on Western blot analysis. In addition, Northern blot analysis showed that CYP1 A2, CYP2E1, CYP2C11, and CYP3A1/2 mRNAs decreased in the state of PCM as well. Hence, pharmacokinetic changes of the drugs in rats with PCM [especially the area under the plasma concentration-time curve from time zero to time infinity (AUC) changes of metabolite(s)] reported from literatures were tried to explain in terms of CYP isozyme changes in the rats. Otherwise, the time-averaged nonrenal clearance ($CL_{NR}$) of parent drug was compared. Pharmacokinetic changes of the drugs in other types of malnutritional state, such as kwashiorkor and marasmus, in both human and animal models were also compared. The drugs reviewed are as follows: diuretics, antibiotics, anticancer agents, antiepileptics, antiarrythmics, analgesics, xanthines, antimalarials, and miscellaneous.

Characteristics in Nutritional Status of Patients on Hemodialysis and Continuous Ambulatory Peritoneal Patients in Chonbuk Area (전북지역 혈액투석 환자와 지속성 외래 복막 투석 환자의 영양상태 비교)

  • 김선형;김숙배
    • Journal of Nutrition and Health
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    • v.36 no.4
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    • pp.397-404
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    • 2003
  • The present study was designed to compare the nutritional status of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Subjects were 58 HD patients (male/female = 29/29) and 33 CAPD patients (male/female = 23/10) undergoing dialysis treatment in Artificial Kidney Unit of Chonbuk National University Hospital. For nutritional assessment, %IBW (ideal body weight), %TSF (tricep skin fold), %MAC (mid arm circumference), %MAMC (mid arm muscle circumference), serum albumin, serum transferrin, TLC (total lymphocyte count), SGA (subjective global assessment) and estimated energy and protein intakes by 1-month food frequency method were used. Between HD and CAPD group, mean age (50 $\pm$ 12 vs. 52 $\pm$ 12 yr), dialysis durations (37 $\pm$ 36 vs. 30 $\pm$ 26 mon), dietary energy intakes (28.3 $\pm$ 9.0 vs. 28.8 $\pm$ 8.6 kcal/kg/day), dietary protein intakes (1.1 $\pm$ 0.4 vs. 1.2 $\pm$ 0.3 g/kg/day) and incidence of co-morbid conditions (69.0% vs. 69.7%) were not significantly different. Data by using SGA showed a higher incidence of malnutrition in CAPD patients (45.6%) than in HD patients (36.2%). %IBW (p < 0.001), %TSF (p < 0.001) and %MAC (p < 0.001) were higher in CAPD patients than were in HD patients. But serum albumin (p < 0.001) and transferrin (p < 0.001) were significantly lower in CAPD patients than were in HD patients. A higher incidence of malnutrition was shown in CAPD Patients than in HD Patients due to different dialysis type. A significant finding was that CAPD showed protein deficient malnutrition and HD did calorie deficient malnutrition. It suggests that an adequate dietary intake considering dialysis type prevents a prevalence of malnutrition.

A Nutrition Intakes Survey of Urban Slum and Rural Areas (한국의 도시빈곤지역과 농촌의 영양섭취 설태)

  • Jung, Hae-Kyung;Kim, Sook-He
    • Journal of Nutrition and Health
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    • v.15 no.4
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    • pp.290-300
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    • 1982
  • The study deals with the empirical research on the condition of nutrient intake of low income class which be represented by urban slum and rural area, with the analysis of the factors which might influence on the prevalent condition of nutrient- intake. The method of the research was based on the spot-survey with questionaires. The result is that the levels of nutrient-intake are below the standard requirement level of nutrients in both of urban slum and rural area. The level of nutrient intake in urban slum lies in approximately 50% of the standard requirement level and 80% of the standard requirement level in rural area. The extent of malnutrition was explained in terms of the amount of calorie, protein, calcium and iron. More than half of the population in the community are below the standard requirement level of the nutrient- intake. The problem of malnutrition was serious in urban slum than in rural areas, which made a good contrast with the result of Peru study. Deficiency in calcium was most serious. The factor analysis of the prevalent condition of malnutrition in low class suggests that 1) The function of local market in supplying food is not so effective in the sense that the quality of the foods purchased id the local market is poor. 2) Low level of knowledge, the consequent ignorance and the indifference to the nutrition and the low income led to malnutrition. The level of income and the education were significantly correlated to the nutrient-intake.

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