| Theme | Nutritional Guidance for Hemodialysis Patients with Complications | |
|---|---|---|
| Title | Disturbances in motor function in dialysis patients and nutritional education of dialysis patients | |
| Publish Date | 1998/12 | |
| Author | Toshihiro Sakurai | Department of Internal Medicine, Oyama Municipal Hospital |
| Author | Kayoko Miyamoto | Department of Nutrition, Jichi Medical School |
| [ Summary ] | Disturbances in motor function of dialysis patients are often associated with neurological disorders, as well as bone and joint disorders associated with renal osteodystrophy. Uremic neuropathy and cerebrovascular diseases (CVD) are main the contributors to neurological disorders. Uremic neuropathy often occurs in underdialysis states but may be corrected with adequate protein intake and dialysis. Cerebral hemorrhaging is more frequent than cerebral infarction in dialysis patients, because high blood pressure due to overhydration sometimes reaches an extreme degree. To reduce the risk of CVD and heart failure, weight gains between each dialysis session must be controled to within 5% of dry body weight, and dietary salt intake should be restricted to 5-7g per day. Secondary hyperparathyroidism (2°HPT) occurs in patients with poor phosphate control. Medications with phosphate binders, vitamin D parathyroidectomy, and protein restriction to less than 60g per day are quite important in preventing 2°HPT. Aluminum osteopathy may be prevented by avoiding aluminum-containing medicines and cooking aluminum pans. Dialysis with high performance membranes may slow down the progression of amyloidosis. Once patients develop these complications, they suffer from a poor quality of life. Since adequate dietary habit can reduce these complications in dialysis patients, nutrition education should be emphasized and repeated. |
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