臨牀透析 Vol.23 No.12(1)


特集名 合併症を伴った維持透析患者の栄養管理
題名 ［総論］透析患者の合併症の現状と栄養学的問題
発刊年月 2007年 11月
著者 加藤 明彦 浜松医科大学附属病院血液浄化療法部
著者 市川 和子 川崎医科大学附属病院栄養部・管理栄養士
【 要旨 】 透析患者の合併症は多岐にわたる．とくに透析患者が高齢 (75歳以上)，長期透析 (10年以上)，糖尿病や心血管病の既往歴がある場合は，栄養障害を合併しやすく，入院時にはきめこまかい栄養管理が必要となる．しかし，通常の透析食のみでは多彩な合併症への食事対応は困難である． しかも透析患者用のアミノ酸製剤や経腸栄養剤がなく，合併症に対して十分なエネルギーやたんぱく質を補給できない可能性がある．今後は，透析患者の病態に合わせたアミノ酸製剤や経腸栄養剤の開発など，低栄養の透析患者に対する栄養補充療法の確立が望まれる．
Theme Nutritional Managements for Maintenance Dialysis Patients with Clinical Complications
Title Current aspects of dialysis complications and nutritional problems
Author Akihiko Kato Division of Blood Purification, Hamamatsu University School of Medicine
Author Kazuko Ichikawa Department of Nutrition, Kawasaki Medical School Hospital
[ Summary ] The number of diseases complicating maintenance dialysis is currently large and increasing. This is especially so in dialysis patients over 75, long-term dialysis patients (over 10 years of treatment), as well as those with diabetes or a previous history of cardiovascular disease. These patients often suffer from malnutrition and need careful nutritional management. However, it is difficult to maintain nutritional status by employing regular dialysis diets. In addition, there are no special enteral feeding or parenteral amino acid products with disease specific formulas for dialysis patients. Thus, it is difficult to provide sufficient energy and protein intake for a variety of diseases. Future studies are required to establish nutritional supplementation by developing new products specially formulated for malnourished dialysis patients.
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