臨牀透析 Vol.34 No.5(5)


特集名 透析患者の体力と認知力を考える―患者と家族が満足するキュアとケア
題名 フレイルを予防する食事
発刊年月 2018年 05月
著者 加藤 明彦 浜松医科大学医学部附属病院血液浄化療法部
【 要旨 】 地域居住高齢者では,フレイルにはたんぱく質摂取量の低下のみならず,朝食時たんぱく質摂取不足,脂肪摂取量の増加,孤食,口腔の問題などが関与する.一方,透析患者ではエネルギーおよびたんぱく質摂取不足がおもな原因である.透析時の栄養補給により,栄養および炎症指標,通常歩行速度などの身体機能が改善する.通常,高齢者では少なくとも1.0~1.2g/kg理想体重/dayのたんぱく質摂取がフレイルの進行予防に必要である.したがって,十分な透析量およびポリファーマシー回避を配慮したリン吸着薬を組み合わせたうえで,必要なエネルギーおよびたんぱく質を摂取することが,透析患者のフレイル予防において重要である.
Theme Practical approach to improve physical and cognitive function of patients on chronic dialysis: Points of satisfaction for patients and their families
Title Diet therapy for the prevention of frailty
Author Akihiko Kato Blood Purification Unit, Hamamatsu University Hospital
[ Summary ] Frailty is a common finding among community-dwelling older adults. This condition is associated with a lower intake of total dietary protein, a lower morning intake of protein, a higher fat intake, eating alone, and oral health problems. In contrast, among patients undergoing dialysis, frailty is primarily related to poor dietary intake of energy and protein. Nutritional supplementation provided at the time of their dialysis visits can improve nutritional and inflammatory parameters in patients, as well as their physical function such as their usual walking speed. An elderly patient usually requires consumption of at least 1.0-1.2 g/kg ideal body weight of protein per day to prevent the progression of frailty. Thus, patients undergoing dialysis require adequate quantities (supply/sources) of dietary energy and protein to prevent frailty, combined with an adequate dose of dialysis and the administration of phosphate binders avoiding polypharmacy.
戻る