臨牀透析 Vol.24 No.4(2-7)


特集名 透析医療における臨床研究の現状と課題
題名 透析合併症 (7) 栄養障害
発刊年月 2008年 04月
著者 菅野 義彦 埼玉医科大学腎臓内科
【 要旨 】 透析療法に関する技術が進歩し,導入後の予後が著しく改善していることから,長期透析患者が増加している.これらの患者には低栄養状態が発生しやすいが,これによりいろいろな合併症の危険が増加するため,さまざまな手段を用いて対策を立てる必要がある.日本腎臓学会の食事指導ガイドラインを遵守することが基本的戦略であるが,それを指導する医療スタッフの指導内容そのものを見直す機会も必要であるし,ファストフードやコンビニエンスストアの食品が食卓に増えた国民全体の食生活の変化にも対応しなければならない.また場合によっては経腸管,経静脈による栄養補助を検討する必要がある.
Theme Current Problem of Clinical Studies in Dialysis Therapy
Title Management of malnutrition in patients receiving dialysis therapy
Author Yoshihiko Kanno Department of Nephrology, School of Medicine, Faculty of Medicine, Saitama Medical University
[ Summary ] To maintain whole body function, it is important to avoid malnutrition in patients receiving dialysis therapy. A guideline is available for nutrition control from the Japanese Society of Nephrology for patients receiving dialysis. However, it may be difficult for patients to comply. Occasionally, methods for teaching dietary control should be evaluated. It has been observed in this dialysis unit, that our instructions to patients have a tendency to restrict their food intake. By changing this tendency, patient protein and energy intake increased approximately 10 % . Recently, fast food, processed food, and store bought food have become common in Japanese households. Because these foods are difficult to resist, considerations must be made to incorporate or control their intake through patient education.
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