臨牀透析 Vol.21 No.13(4-1)


特集名 年齢・病態に見合った腎不全患者の栄養管理
題名 腎移植患者の栄養管理 (1) 小児
発刊年月 2005年 12月
著者 板橋 淑裕 東邦大学医学部腎臓学教室
著者 相川 厚 東邦大学医学部腎臓学教室
【 要旨 】 慢性腎不全の治療は血液透析,腹膜透析,腎移植の三つの選択肢があるが,中学生以下の小児においては腹膜透析が主流である.しかしながら,小児腎不全治療の目標である成長発達の改善を期待できるのは腎移植である.近年,preemptive腎移植も評価されてきている.腎移植後は腎機能が正常化するため普通児と同じく年齢に応じた栄養管理を行い,原則として食事制限の必要はない.しかし,過食や偏食 (高脂肪や食塩および糖分過多) は免疫抑制薬の副作用と相まって肥満や高血圧を生じるリスクがある.
Theme Nutritional Management of Patients with Renal Failure -- Suitable for Ages and Clinical Conditions
Title Management of nutrition after pediatric renal transplantation
Author Yoshihiro Itabashi Department of Nephrology, Toho University School of Medicine
Author Atushi Aikawa Department of Nephrology, Toho University School of Medicine
[ Summary ] End-stage renal disease in pediatric patients impairs growth despite dialysis. However, renal transplantation has been considered the most optimal treatment which in achieving normal growth and development. Basically, post-transplant nutrition should not be restricted in order to catch up on growth which has been showed due to bone remolding and anemia. Excess intake of lipids, salt and sugar result in obesity, hyperglycemia, hypertension, and hyperlipidemia, combined with the metabolic side effects of immunosuppressive drugs. Well balanced nutrition can prevent complications in childhood as well as adult post-transplantation cases. If these measures are taken, pediatric renal transplant patients may be treated with proper nutritional management.
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