| 特集名 | 合併症を伴う透析患者の栄養指導 | |
|---|---|---|
| 題名 | 栄養障害 (1) 成人 | |
| 発刊年月 | 1998年 12月 | |
| 著者 | 小山 美住 | 東京女子医科大学附属病院栄養部 |
| 著者 | 佐中 孜 | 東京女子医科大学附属病院腎臓病総合医療センター第四内科 |
| 【 要旨 】 | 透析患者が一度，栄養障害に陥ると，その改善には長時間を要し，栄養障害が患者の予後に悪影響を及ぼすことさえある． このような栄養障害を避けるためには，次のことを実行することが必要と考える．1) 糖，蛋白，脂質などの慢性腎不全に伴う本質的な代謝障害の程度を患者ごとに把握し，総体としての栄養状態を頻回に評価する．2) これらのデータをもとに，栄養所要量を決定し，食事摂取向上のための工夫を凝らす．3)患者自身に栄養管理の必要性を認識させる．4)栄養指導の実行に当たっては，医師をはじめとする関係スタッフ，さらには患者とその家族を巻き込む． 最後に，透析患者の予後を良好に維持するためには，食事療法の教育が透析療法や薬剤による治療と同程度に重要である旨を強調したい． |
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| Theme | Nutritional Guidance for Hemodialysis Patients with Complications | |
|---|---|---|
| Title | Malnutrition -- Adult | |
| Author | Misumi Koyama | Department of Nutrition, Tokyo Women's Medical University |
| Author | Tsutomu Sanaka | 4th Department of Internal Medicine, Tokyo Women's Medical University |
| [ Summary ] | Once dialysis patient fell into malnutrition, a long time is required for the improvement. Malnutrition causes the adverse effect even for prognosis of the patient. It is thought that the following execution is necessary to avoid such malnutrition. 1) The severity of the essential metabolic disorder in an individual patient with chronic renal failure is understood, and nutritional state as the whole is evaluated frequently. 2) Nutritional requirement is decided based on these date, and a great deal of effort is put into the diet therapy to improve the meal intake. 3) The patient is made to recognize the necessity of the nourishment control. 4) When nutritional education to the patient is begun, it is necessary to involve not only the related staff including doctors, but also the patients and their family. Finally, we want to emphasize the importance of the education of the nutritional diet to the same extent as the therapeutic dialysis and the medication. |
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