The Japanese Journal of Clinical Dialysis Vol.21 No.1(8-7)

Theme Dialysis in Diabetic Patients
Title Nutritional deficits -- meeting patients' nutritional needs related to education
Publish Date 2005/01
Author Yumiko Iwahara Department of Nutrition, Shinnraku-en Hospital
Author Eikichi Watanabe Department of Nutrition, Shinnraku-en Hospital
Author Masashi Suzuki Department of Medicine, Shinnraku-en Hospital
[ Summary ] Among dialysis patients who also have comobidity related to diabetes, it is more common for them to have nutritional deficits compared to those who do not. Low protein/energy diets usually lead to low nutritional intake. There are a few preventative measures, such as receiving sufficient dialysis, controlling the progression of protein catabolism, getting adequate exercise, increasing nutritional intake etc. In order to increase nutritional intake, it is necessary to meet personal needs by educating patients. If the patients' poor appetite results in inadequate nutritional intake, we need to educate those patients on how to eat small amounts each time, depending on their needs. Education on salt intake is also essential for patients who decrease their dietary intake during dialysis. Patients who control dietary intake in order to prevent high potassium and high phosphorus levels, need to receive high quality protein, about 1.0-1.2g/kg/day. These patients also need to be directed to eat snacks between meals to control blood sugar levels. It is very important to involve patients' family members at the start of nutritional education. It better to develope understanding with the use of the same food exchange chart from the beginning of treatment.
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