| Theme |
Protein-energy wasting and potentiality of NST in dialysis patients |
| Title |
Nutritional disorders and a possibility of nutritional support team in dialysis patients |
| Author |
Akihiko Kato |
Blood Purification Unit, Hamamatsu University School of Medicine |
| [ Summary ] |
The role of nurses in nutritional support teams (NST) is important for dialysis units with a limited number of co-medical stuff members. Nurses are required to select dialysis patients at high risk due to poor nutrition. The Geriatric Nutritional Risk Index (GNRI) is useful for screening dialysis patients at high risk of malnutrition. The GNRI is not useful for assessing dietary energy and protein intake. It is necessary to further assess dietary intake for patients diagnosed as being at nutritional risk due to GNRI. Registered dieticians prescribe enteral nutritional formulas according to patients' dietary intake and disease conditions. If nutritional counseling and oral nutritional supplements are unsuccessful, clinical pharmacists should create intradialytic parenteral nutrition (IDPN) therapy. Clinical engineers must also propose appropriate dialysis doses, proper dialyzer membranes and dialysates for malnourished patients. These multi-disciplinary approaches will help us to identify dialysis patients at high risk, and be able to prevent the development of protein-energy wasting. We expect to establish evidence concerning the efficacy of NST for dialysis patients in the near future. |