Hemodialysis malnutrition, these diet points should be noted

The probability of malnutrition in end-stage renal disease patients with

can reach 30%-60%. Studies have shown that 23%-76% of hemodialysis patients and 18%-50% of peritoneal dialysis patients have malnutrition.

Therefore, the nutritional management of dialysis patients is a key issue that medical staff and dialysis patients should pay attention to.

Why are dialysis patients prone to malnutrition?

1. Lack of nutritional knowledge is the main cause of malnutrition in hemodialysis patients.
2. Insufficient dialysis and excessive dialysis medication. Some medications stimulate the gastric mucosa, resulting in poor appetite and insufficient protein intake.
3. The loss of amino acids and trace elements during dialysis can lead to varying degrees of malnutrition.
4. patients with glucose metabolism, lipometabolism disorders .
5. Anemia, erythropoietin deficiency, elevated parathyroid hormone and toxins from uremia can all cause malnutrition.

The main indicators for assessing malnutrition in dialysis patients

Subjective comprehensive evaluation (SGA) other indicators

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(2) Diet changes: with or without dietary restrictions, duration, type of food

(3) Digestive symptoms: anorexia, nausea, vomiting, diarrhea, duration of serum albumin_ span3span prealbumin creatinine and its index Serum cholesterol and urea nitrogen protein level (PNA) protein breakdown rate (PCR) fat removal and edema weight

2, physical examination

(1) Subcutaneous fat loss

(2) Muscular atrophy

The hazards of malnutrition in dialysis patients

The mortality of malnutrition in hemodialysis patients is closely related to the mortality rate of malnutrition in hemodialysis patients. Malnutrition can lead to a decline in the immune function of hemodialysis patients and more likely to have complications. The release of inflammatory factors can cause malnutrition to worsen.
At the same time, inflammatory factors promote the occurrence and development of atherosclerosis through inflammatory mechanisms. The three form a vicious circle, which increases the incidence of cardiovascular complications in hemodialysis patients and promotes a significant increase in patient mortality.

Dietary Guidelines for Dialysis Patients

Protein intake

is mainly based on high-quality protein, 1.2 g/(kg/day) of acute hemodialysis patients When sick,The protein intake should be increased to 1.3 grams (kg/day). Membrane dialysis patients 1.2-1.3 grams (kg/day) can eat 2 eggs a day, 50 ml milk, and moderate amounts of fish and meat.

calorie intake

recommended 146kJ/(kg/day) 1_span [3span/day, over 60kcal/span] Smaller ones with good nutritional status can be reduced to 125-146 kJ/(kg/day) [30-35 kcal/(kg/day)].

Phosphate limit

Long-term high phosphorus and low calcium can cause metabolic bone disease, mainly bone pain. Therefore, you should eat less foods high in phosphorus, you can also add phosphorus binders such as calcium carbonate, chewing while eating, can reduce the absorption of phosphorus.

potassium restriction

Because of the decrease in potassium excretion, dialysis patients should eat less food with hyperkalemia during the dialysis period.

Low fat

Dialysis patients are often accompanied by lipid metabolism disorders.In order to avoid atherosclerosis and cardiovascular and cerebrovascular diseases, low-fat diet should be appropriate.

limited salt

For dialysis patients with hypertension, we should also pay attention to a low-salt diet.

In short, 's correct and reasonable diet can reduce the complications of kidney disease, help control the disease, and slow down the development of kidney disease. In specific life practices, it should also be based on Individuals make different plans that suit them.

The source of this article: Jingdong Yumei Kidney Hospital, reprinted for non-commercial use only for communication and learning

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