exudates and Water-Electrolyte-Imbalance

The relationship between hypertension and fluid overload in pre-dialysis CKD patients need to be elucidated. Current study aimed to find relationship between fluid overload and hypertension along with prescribed diuretic therapy using bioimpedance spectroscopy (BIS).. A prospective observational study was conducted by inviting pre-dialysis CKD patients. Fluid overload was assessed by BIS.. BIS can aid clinicians to categorize CKD patients on basis of their fluid status and provide individualized pharmacotherapy to manage hypertensive CKD patients.

Topics: Aged; Blood Pressure; Body Composition; Dielectric Spectroscopy; Diuresis; Diuretics; Drug Prescriptions; Electric Impedance; Female; Glomerular Filtration Rate; Humans; Hypertension; Kidney; Malaysia; Male; Middle Aged; Practice Patterns, Physicians'; Predictive Value of Tests; Prevalence; Prospective Studies; Renal Insufficiency, Chronic; Treatment Outcome; Water-Electrolyte Balance; Water-Electrolyte Imbalance

The effectiveness of the Nutrition Support Team (NST) at Hospital Sungai Buloh, a large public hospital in Kuala Lumpur, Malaysia, in optimising parenteral nutrition (PN) has not been evaluated. To evaluate the effects of this NST in optimising patient outcomes, treatment outcomes, and adherence to biochemical monitoring guidelines, two groups of patients, those given PN before (n = 106) NST intervention and those given PN after (n=106) NST intervention, were retrospectively compared. Intervention by the NST significantly reduced metabolic abnormalities, reducing sodium abnormalities from 67% to 44% (p<0.01); potassium abnormalities from 42% to 15% (p<0.01); magnesium abnormalities from 13% to 3% (p<0.05) and phosphate abnormalities from 21% to 9% (p=0.01). Intervention by the NST also significantly reduced the incidence of hypertriglyceridemia from 68% to 45% (p=0.002) and significantly improved adherence to biochemical monitoring guidelines from 46% to 72% (p<0.01). However, the length of hospital stay, patient mortality, and duration of PN were similar in both groups. This study failed to demonstrate that the establishment of a NST gave better outcomes in terms of the common measures of effectiveness. In conclusion, although management by an NST significantly reduced metabolic abnormalities and improved adherence to biochemical monitoring guidelines, the NST did not improve patient mortality rates and length of hospital stay.. 位於馬來西亞吉隆坡的一所大型公立醫院-Sungai Buloh 醫院，其營養支持小組 (NST)對於優化靜脈營養(PN)的效益尚未被評估。兩組病人，一組為NST 介入 前給予PN (106 位)，另一組則在NST 介入後給予PN (106 位)。回溯性比較以 評估NST 對於病人的治療結果及生化監測指南的遵從性之優化效果。NST 介入 顯著降低代謝性異常，降低鈉異常由67%至44% (p<0.01)；鉀異常從42%至 15% (p<0.01) ； 鎂異常從13%至3% (p<0.05) 及磷酸鹽異常從21%至8% (p=0.01)。NST 介入也顯著降低高三酸甘油酯血症發生率從68% 至45% (p=0.002)及改善生化監測指南的遵從性由46%到72% (p<0.01)。然而，兩組的 住院天數、病人死亡率及接受PN 期間則相似。以常用的效益測量為指標來 看，這個研究無法證明NST 有較好的結果。總之，雖然NST 的管理顯著地降 低代謝性異常及改善生化監測指南遵從性，但並未改善病人死亡率及住院天 數。

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Hypertriglyceridemia; Length of Stay; Malaysia; Male; Metabolic Diseases; Middle Aged; Parenteral Nutrition; Patient Care Team; Retrospective Studies; Treatment Outcome; Water-Electrolyte Imbalance