| [ Summary ] |
Protein-energy wasting is a common complication observed in patients with chronic kidney disease, particularly in maintenance dialysis patients. Elderly patients, diabetics, and long term dialysis patients are often observed with this condition along with associated nutritional disorders. There are many causes of protein-energy wasting, due to inadequate protein and energy intake, inflammation, nutritional loss into dialysates, metabolic acidosis, and endocrine disorders. Protein-energy wasting is closely associated with higher morbidity and mortality, therefore nutritional management is necessary to prevent malnutrition and to maintain optimum nutritional status. A nutrition support team (NST) was developed with members who were dietitians, doctors, pharmacists, and nurses in 2005 to manage the nutritional status of hospitalized dialysis patients. Because nutritional management not only of hospitalized patients but also of outpatients is important, we added nurses from outside dialysis facilities to our NST in 2005. We also developed an original system to easily evaluate patient nutritional status and to track progress. Our NSTs are striving to improve hospital care and to develop consistent nutritional evaluation and support systems for dialysis patients to prevent and/or ameliorate protein-energy wasting. |