透析患者における食物線維摂取 -臨床的, 食品学的検討-

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  • Dietary fiber intake in maintenance dialysis patients

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Dietary fiber intake in 45 hemodialized and 21 CAPD patients were calculated on the basis of a precise diet history of two days duration. At the same time, serum K and cholesterol were measured in the same patients. Furthermore, the relationship between dietary fiber content and potassium content in 94 foods was analyzed.<br>Dietary fiber intake was 9.73±2.65g/day in hemodialized patients and 11.08±3.84g/day in CAPD patients. These values were significantly lower than that of 20 healthy controls whose dietary fiber intake was 13.46±3.85g/day (p<0.005). There was no correlation between dietary fiber intake and serum K levels in either hemodialized or CAPD patients. Although CAPD patients consumed more dietary fiber than hemodialized patients, serum K levels in CAPD patients (4.04±0.63mEq/l) were significantly lower than in hemodialized patients (4.96±0.93mEq/l). There was an inverse relationship between dietary fiber intake and serum total cholesterol levels in diabetic CAPD patients (r=-0.573, p<0.05). Dietary fiber content in the food was correlated with overall potassium content (r=0.694, p<0.001), however, we found several foods in which potassium content was low in spite of high dietary fiber content (K/dietary fiber content ratio below 0.1), for example, oatmeal, cornflakes, mushrooms and boiled vegetables.<br>From our study, dietary fiber intake in maintenance dialysis patients was low, and this might be disadvantageous for the prevention of arteriosclerosis Thus more dietary fiber intake should be recommended for these patients. To attain higher dietary fiber intake and simultaneously prevent hyperkalemia in dialysis patients, CAPD might be better than hemodialysis. However, even in hemodialized patients, this could be accomplished by consuming foods in which the K/dietary fiber content ratio is low.

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