| 特集名 | 透析患者向け治療食の最先端 | |
|---|---|---|
| 題名 | ［最新栄養学を透析患者にどのように取り入れるか！将来展望］栄養改善における重要なアミノ酸とは？ | |
| 発刊年月 | 2017年 11月 | |
| 著者 | 椿原 美治 | 滋慶医療科学大学院大学医療安全管理学研究科 |
| 【 要旨 】 | 正常に摂食可能な透析患者では，40年以上の長期生存例が存在することから，通常の蛋白・アミノ酸摂取内容で問題はないと考える． 一方で，高齢化や糖尿病腎症患者の増加とともに，栄養不良患者が増加している．透析患者の蛋白・アミノ酸代謝異常の最大の要因は経口摂取不足と身体活動の低下である．健常人や運動選手の筋肉増強などを目的とした特定のアミノ酸の候補はあるが，このような透析患者の栄養改善効果は実証されていない． 実臨床では，市販の腎不全用アミノ酸製剤とブドウ糖，脂肪製剤を使用した透析中の静脈投与が有効であるが，蛋白代謝の観点からは運動療法の併用が不可欠である． |
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| Theme | Forefront of therapeutic food for dialysis patients | |
|---|---|---|
| Title | Role of essential amino acids in nutritional improvement for dialysis patients | |
| Author | Yoshiharu Tsubakihara | Course of Safety Management in Health Care Sciences, Graduate School of Health Care Sciences, Jikei Institute |
| [ Summary ] | Dialysis patients may sur vive for over 40 years. Therefore, it is thoght no problem with ordinary protein/amino acid intake exists. On the other hand, the number of malnourished patients has increased with the aging of our population as well as increased numbers of patients with diabetic nephropathy. The most important cause of protein and amino acid metabolism abnormalities in dialysis patients is lack of oral intake and a decrease in physical activity.There are specific amino acid candidates for physical strength in healthy people and athletes, but they have not been demonstrated for use in dialysis patients. In clinical practice, intradialytic parenteral nutrition using commercially available amino acid preparations for renal failure, including glucose and fatty preparations are effective. However, from the viewpoint of protein metabolism it is indispensable we combine them with exercise therapy. |
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