特集名 | 栄養障害に陥った腎不全患者のケア -- 医師・栄養士・看護師の連携 | |
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題名 | 総論 II. 血液透析患者の栄養管理 | |
発刊年月 | 2002年 12月 | |
著者 | 石崎 允 | 永仁会病院腎センター |
【 要旨 】 | 日本透析医学会の透析療法統計調査において,生命予後因子の一つとして栄養障害を取り上げ,その指標に%クレアチニン産生速度や血清クレアチニン透析前値をあげている.これらは至適透析の条件下では,筋肉量や栄養状態を反映しているので,高値群ほど栄養状態が良好であり,死亡率は低く,合併症および入院頻度も少ない. われわれも透析患者の栄養管理の重要性を認識し,栄養障害対策を医師・管理栄養士・看護師・臨床工学技士の連携のもとに対応している.現在,NST(nutrition support team)が定期的にミーティングをもち,血液透析患者の栄養障害を総合的に分析して,現時点で最良と思われる栄養療法を心がけている.今回,われわれが行っている血液浄化療法における栄養管理の考え方を述べる. |
Theme | Care of Patients with Chronic Renal Failure under Malnutrition -- The Teamplay of Physicians, Nutritionists, and Nurses | |
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Title | Nutritional management of hemodialysis patients | |
Author | Makoto Ishizaki | Kidney Center, Eijinkai Hospital |
[ Summary ] | A statistical analysis of dialysis therapy conducted by The Japanese Society for Dialysis Therapy has shown that malnutrition is a common factor associated with an increased mortality rate in hemodialysis patients. The percentage of creatinine generation rates and pre-dialysis serum creatinine values are described as indices of nutritional status. Since these indices, under optimal dialysis dose, reflect the muscle mass and nutritional status of hemodialysis patients, higher values of indices reflect a better nutritional status, lower mortality and morbidity rates and lesser hospitalizations. Due to the recognition of the importance of nutritional management for dialysis paients, we have been strategically dealing with mal nutrition through a team of physicians, nutritionists, nurses and clinical engineers. At present this nutrition support team (NST) holds meetings periodically and comprehensively analyses malnutrition in hemodialysis patients, to provide the best nutritional intervention. The concept of nutritional management in the hemodialysis treatment is described. |