The Japanese Journal of Clinical Dialysis Vol.25 No.13(2-2)

Theme Strategies of Parenteral and Enteral Nutrition in Patients with Chronic Kidney Disease Especially at Stages 4 and 5
Title Glyconutrition of patient with the chronic kidney disease stages 4, 5 and 5D
Publish Date 2009/12
Author Yasuyuki Nagasawa Department of Geriatric Medicine & Nephrology, Osaka University Graduate School of Medicine
[ Summary ] It is important that patients with end stage renal disease (ESRD), as well as those without ESRD, control their nutrition status. Low protein, high calorie diets are favorable for ESRD patients. Moreover, in cases where intravenous hyperalimentation (IVH) is necessary, it may be difficult to metabolize amino acids. Therefore, an adequate supply of glucose becomes more important. If there is no space for IVH, it is necessary to reduce fluid volume with hemodialysis in order to supply adequate nutrition. Glucose infusions should begin with low grade glucose concentrations and increase incrementally to adequate levels. The control of blood glucose levels is important, and those levels must be evaluated every two hours after changeing IVH routines such as the rate of infusion, or glucose concentrations. Glucose levels should be evaluated every day even though there has been no change in IVH routines. IDPN (intra-dialysis parenteral nutrition) is an alternative way to supply nutrition for hemodialysis patients.
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