【摘要】 目的 评估血液透析期间香蕉摄入量对维持性血液透析患者(maintenance hemodialysis, MHD)血清钾水平的影响。方法 本研究为单中心、随机对照临床试验,于2021年9月15日至12月15日选取中国南方地区1所三级甲等医院的126例MHD患者,并将其随机分为干预组(n=64)和对照组(n=62)。干预组患者在血液透析期间摄入约250克香蕉,而对照组患者在血液透析期间不摄入任何食物。在血液透析前通过病例信息收集患者人口学信息和血液透析相关参数,通过采集患者透析前血液样品来评估实验室指标(如血常规、生化指标、炎症指标、肝功能、肾功能等)。在血液透析2 h和4 h、下次血液透析前分别测量两组患者的血清钾和血糖水平,并记录透析中相关并发症。采用重复测量方程分析对两组患者血清钾和血糖指标进行比较。结果最终122例MHD患者完成研究(干预组和对照组各61例)。结果显示,两组患者血清钾水平在组别和时间上不存在交互作用(P>0.05),而干预组患者血清钾水平在血液透析2 h(3.9±0.5比3.6±0.3) mmol/L和血液透析4 h(3.5±0.4比3.3±0.3) mmol/L均高于对照组(P<0.01)。两组患者血糖水平在组别和时间上不存在交互作用(P>0.05)。干预组患者在血液透析期间心律失常(8.2%比29.5%,P=0.003)和低钾血症的发生率(52.5%比80.3%,P=0.002)均低于对照组。结论 血液透析开始时摄入约250 g香蕉不会引起高钾血症,可有效降低低钾血症和心律失常的发生率,并防止血液透析过程中血清钾水平下降过快。建议医务人员应与营养学家进一步合作,为MHD患者制订适用的膳食管理计划。更多还原

【Abstract】 Objective: This study aimed to assess the effect of banana intake during hemodialysis on serum potassium levels in maintenance hemodialysis(MHD) patients.Methods: This study was a single-center, randomized controlled clinical trial conducted from September 15 to December 15, 2021, at a tertiary hospital in southern China. A total of 126 MHD patients were randomly assigned to either the intervention group(n = 64) or the control group(n = 62). Patients in the intervention group consumed approximately 250 g of bananas during hemodialysis, while those in the control group did not consume any food during hemodialysis. Demographic information and hemodialysis-related parameters were collected through case information collection before hemodialysis. Laboratory indicators(such as complete blood count, biochemical indicators, inflammation markers,liver function, kidney function, etc.) were evaluated by collecting pre-hemodialysis blood samples from patients. Serum potassium and blood glucose levels were measured at 2 h and 4 h of hemodialysis, as well as before the next hemodialysis session, and hemodialysis-related complications were recorded. The blood potassium and blood glucose indicators during hemodialysis were compared using repeated measures analysis.Results: A total of 122 MHD patients completed the study(61 in each group). The results showed that there was no significant interaction between group and time on serum potassium levels. However, serum potassium levels in the intervention group were higher than those in the control group at 2 h(3.9 ± 0.5 mmol/L vs. 3.6 ± 0.3 mmol/L, P < 0.01) and 4 h(3.5 ± 0.4 mmol/L vs. 3.3 ± 0.3 mmol/L, P < 0.01)of hemodialysis. There was no interaction between group and time on blood glucose levels. The incidence of arrhythmias(8.2% vs. 29.5%, P = 0.003) and hypokalemia(52.5% vs. 80.3%, P = 0.002) during hemodialysis was significantly lower in the intervention group compared to the control group.Conclusion: Consuming approximately 250 g of bananas at the start of hemodialysis does not lead to hyperkalemia. It can effectively reduce the incidence of hypokalemia and arrhythmias, and prevent a rapid decline in serum potassium levels during hemodialysis.更多还原