臨牀透析 Vol.25 No.12(2-7)


特集名 腎代行治療導入患者への医療情報提供を考える
題名 末期腎不全患者への医療情報提供と準備(7)管理栄養士の役割
発刊年月 2009年 11月
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 】 管理栄養士は,CKD(慢性腎臓病)治療において重要とされる食事療法の分野を担っている.しかし,外来では,薬物のように実際に服用できるものを提供することはできない.栄養教育を通して患者に病態に応じた食事のあり方を説いている.できるだけ具体的にわかりやすく示すことにより,患者自らが病態を理解し,受け入れ,実践できるようにサポートすることが役割である.さらに加えるなら,CKDステージ5においては,食事指導にとどまらず患者の生活全般を視野に入れ,スムーズな透析導入を医師とともにインフォームドコンセントにより導くことも管理栄養士の重要な使命と考える.
Theme Informed Consent and Preparation on Renal Replacement Therapy for Patients with End Stage Renal Disease
Title Providing information and preparation for initiation of renal replacement therapy : Role of registered dietitians
Author Kazuko Ichikawa Department of Nutrition, Kawasaki Medical School Hospital
[ Summary ] Registered dietitians are responsible for providing dietetic therapy, which is an important component in the management of chronic kidney disease (CKD). Unlike pharmacists, registered dietitians are unable to provide medications in outpatient situations. Their duty is to assist patients in understanding foods suitable for their individual clinical states by providing nutritional education. The roles of registered dietitians include supporting patients in putting the dietary information received into practice, as well as helping patients understand and accept their clinical states by providing information on food contents in a detailed and easily understood manner. In the case of patients in stage 5 CKD who are beginning renal replacement therapy, the role of registered dietitians extends further to encompass more than providing guidance on diet therapy. At that time, the most important mission of registered dietitians is to examine all aspects of patients' lifestyles and together with doctors, facilitate the efficient induction of dialysis by obtaining informed consent from patients starting renal replacement therapy.
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