| 特集名 | 腎疾患患者の食事援助 -- 治療用特殊食品の利用 | |
|---|---|---|
| 題名 | 低甘味ブドウ糖重合体製品 (2) 腎臓食への応用 | |
| 発刊年月 | 1997年 10月 | |
| 著者 | 市川 和子 | 川崎医科大学附属病院栄養部・栄養士 |
| 著者 | 寺本 房子 | 川崎医科大学附属病院栄養部・栄養士 |
| 著者 | 河原 和枝 | 川崎医科大学附属病院栄養部・栄養士 |
| 【 要旨 】 | 腎不全の食事療法はたんぱく質の制限下で，常に十分な摂取エネルギー量を必要とする．そのためエネルギー源としては，糖質，脂質が中心となる．手短な食品として砂糖があるが，甘味が強いため使用量に限界がある．そこで，水飴を主成分とする低甘味ブドウ糖重合体製品(粉飴，テトラスター®，カロライナー®など)が開発され，広く臨床や家庭で利用されている．今回は，砂糖の代替品としての利用法のみでなく，でんぷんとの併用による糖尿病性腎症食への応用，また，術後，脳血管障害，薬剤等により経口摂取できない腎不全患者の経腸栄養食への活用について紹介する． 低甘味ブドウ糖重合体製品は腎臓食においては有用であると考えるが，今後はさらに急増する糖尿病性腎不全患者に対応するため，血糖への影響がより少なくかつエネルギー源となる糖質製品の開発が望まれる． |
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| Theme | The Support of Nutritional Condition of Patients with Renal Disease -- Foods for special dietary uses | |
|---|---|---|
| Title | Maltdextrins and their application dietary for renal disease | |
| Author | Kazuko Ichikawa | Depertment of Nutrition, Kawasaki Medical School Hospital |
| Author | Fusako Teramoto | Depertment of Nutrition, Kawasaki Medical School Hospital |
| Author | Kazue Kawahara | Depertment of Nutrition, Kawasaki Medical School Hospital |
| [ Summary ] | Nutritional management is essential in the treatment of patients with chronic renal failure. To minimize catabolism and slow the progression of renal disease, a protein-restricted diet with adequate caloric intake has been proposed, but it is not easy to obtain sufficient carbohydrates and fats for proper caloric intake by utilizing routine Japanese foods. Occasionally, patients are advised to simply include more sugar in their diet to balance out the caloricd eficiency. However, sugar is too sweet, and can increase triglyceride synthesis and impair glucos tolerance if it is abnormal. Maltdextrin (kona-ame, Tetrastor, and Caloriner), which is composed mainly of maltotriose, has been widely introduced in hospitals and homes. In this report, three successful dietetic regimens adapting maltdextrin are presented; 1) a regimen in which it has been used as a substitute for sugar. 2) one in which it has been applied together with starch for nutritional management of diabetic nephropathy, and 3) one in which it has been used as a component of enteral nutritional diet therapy for patients with oral intake disorders, such as postoperative states, neuromuscular diseases, and drug-induced gastrointestinal disturbances. All these regimens employing maltdextrin have been shown to be effective in diet therapy for patients with renal diseases. If carbohydrate products, which cause less alteration in glucose metabolism could be industrially developed in the future, they could be applied to nutritional management of patients with diabetic nephropathy, the numbers of whom are rapidly increasing in Japan. |
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