臨牀透析 Vol.22 No.13(2-4)


特集名 慢性腎臓病における食事療法を再考する -- ガイドライン (1997年) は適正か？
題名 慢性腎臓病のステージ別にみた食事療法 (4) 成人維持腹膜透析
発刊年月 2006年 12月
著者 石崎 允 永仁会病院腎センター
【 要旨 】 腹膜透析において，経年的な腹膜劣化により，尿毒素や体液などの除去が不十分となり，それらが栄養状態に強く影響を及ぼす．また，残存腎機能が荒廃して自尿がなくなると，適正な透析量を維持するために，腹腔内へ注入される透析液量が増え，腹部膨満が亢進して食事量が減少する．適正な透析量に加えて，食欲があり，運動も継続できる腹膜透析療法が望まれる．腹膜透析処方を踏まえた食事療法の留意点を述べる．
Theme Reconsidering of Diet Therapy for Patients with Chronic Kidney Disease -- Is the clinical guideline for diet therapy edited by Japanese Society of Nephrology at 1997 valid?
Title Nutrition care and management (NCM) for adult peritoneal dialysis patients
Author Makoto Ishizaki Kidney Center, Eijinkai Hospital
[ Summary ] The function of the peritoneal membrane deteriorates with continued peritoneal dialysis (PD) over long periods. This situation contributes to inadequate dialysis dose such as decreasing both removal of uremic toxins and ultra-filtration. Inadequate dialysis has a strong influence on nutritional status.
In addition, when residual renal function deteriorates, it is difficult to prescribe adequate dialysis dose. The CAPD prescription for increasing dialysis dose, a larger amount of dialysis solution to be indwelled, generally into the abdominal cavity. Therefore, an increase in abdominal hydrostatic pressure produces a decline in appetite. An adequate dialysis prescription, using an APD cycler, may increase appetite, improving nutritional status. Problems with alimentary therapy for peritoneal dialysis may be solved by optimal PD prescription and NCM.
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