| Theme |
Protein-energy wasting and potentiality of NST in dialysis patients |
| Title |
Nutrition disorder of dialysis patients (particularly gangrene patients) and the possibility of nutrition support team |
| Author |
Seiko Takahashi |
Department of Nutrition, Shonan Kamakura General Hospital |
| Author |
Sumi Hidaka |
Department of Blood Purification, Shonan Kamakura General Hospital |
| Author |
Shuzo Kobayashi |
Kidney Disease and Transplant Center, Shonan Kamakura General Hospital |
| [ Summary ] |
Patients undergoing maintenance dialysis are always in hypermetabloic and catabolic states. Any significant wound leads to the patient being in a much more catabolic state with nutritional needs being significantly increased. Wound healing is directly related to the degree of lean body mass (LBM) loss. Therefore, optimum nutrition is well recognized as a key factor in maintaining wound healing. Arginine, glutamine, and HMB are effective in promoting wound healing. We established a system that allows NSTs to intervene automatically after patients are discussed at foot conferences. In order to retrospectively evaluate clinical data concerning patients undergoing hemodialysis with gangrene in their legs, we divided these patients into two groups. They were the survival and non-survival groups, used to compare the serum levels of albumin, transthyretin, and CRP, along with actual intake of energy and protein. The non-survival group showed significantly higher CRP levels after NST intervention. Therefore, the control of infection may be considered a very important issue. Energy and protein intakes were less in both groups as compared to recommendation guidelines. We must make plans to increase energy and protein intake for patients with gangrene who are undergoing hemodialysis therapy. |