Theme |
Strategies of Parenteral and Enteral Nutrition in Patients with Chronic Kidney Disease Especially at Stages 4 and 5 |
Title |
Nutritional management for predialysis and dialysis patients |
Author |
Toshiyuki Nakao |
Department of Nephrology, Tokyo Medical University |
[ Summary ] |
Parenteral and enteral nutrition are effective measures to prevent protein-energy wasting in patients with chronic renal failure who are not able to ingest nutrients orally or whose dietary intake is insufficient. Administration of adequate total energy with carbohydrates and fats is most essential. Energy requirement vary with age, gender, and level of physical activity, and increase with injuries or inflammation. Prescriptions for energy administration should be adjusted in to relation changes in body weight over time. Low protein diets can postpone the initiation of dialysis treatment for patients in predialysis conservative stages. Excessive protein administration should be avoided in patients on dialysis. Administration of vitamins and trace elements is necessary for anorexic patients whose dietary intake is insufficient. |