臨牀透析 Vol.18 No.12(1)


特集名 透析患者における消化管異常
題名 [総論]腎不全における消化管異常
発刊年月 2002年 11月
著者 小沢 潔 平塚共済病院腎臓内科
【 要旨 】 慢性腎不全において食欲不振,吐き気,嘔吐などの消化管症状は高頻度に出現し,しばしば腎機能障害の進展,透析療法開始の直接的な原因となる.透析期に消化管症状が現れた場合,出現時期,随伴症状から透析療法との関係,投与薬剤の影響をまず除外し,原因疾患の究明と病変に対して悪影響を及ぼさない透析の工夫をしなければならない.補助診断としての血液生化学検査は,透析患者特有の正常域を有することを理解したうえで判定する.消化管薬は透析患者では禁忌あるいは減量を要するものが多く,注意が必要である.
Theme Gastrointestinal Complications in Dialysis Patients
Title Digestive tract abnormalities associated with renal failure
Author Kiyoshi Ozawa Department of Nephrology, Internal Medicine, Hiratsuka Kyosai Hospital
[ Summary ] Appetite loss, nausea and vomiting are frequently seen in end stage renal disease (ESRD). These symptoms induce further renal deterioration through dehydration, hyponatremia and metabolic acidosis, which results in need for initiation of dialysis therapy. They are originated from not only gastrointestinal tract disease but also other organ abnormalities. In patients recieving dialysis, the therapy or drug-induced disease must be ruled out as a cause of these symptoms. Serum amylase, transaminases and some tumor-markers are out of normal ranges in dialysis patients. There are many drugs which are contraindicated or which require dose reduction. Careful observation must be done in diagnosis and treatment of digestive disease in patient with ESRD.
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