[Management of malnutrition in chronic hemodialysis]
- PMID: 9836198
[Management of malnutrition in chronic hemodialysis]
Abstract
Malnutrition is an independent factor of morbidity and mortality in hemodialysis patients. Therefore, the nutritional management must be included in the follow-up and treatment of these patients. During hemodialysis, estimated nutritional requirements are 35-40 kcal/kg/day and 1.2-1.4 protein/kg/day. Dietary counseling, performed twice a year, makes it possible to detect the early signs of undernutrition. High risk malnutrition can be identified by the following indicators: normalized catabolic rate < 1 g/kg/j, serum albumin < 35 g/l, serum prealbumin < 300 mg/l. A trimestrial measurement of these variables is recommended. A schematic diagram is proposed for the nutritional management of malnourished hemodialysis patient. The occurrence of malnutrition implies to look for any cause of anorexia or hypercatabolism such as inadequate nutritional intakes, inadequate dialysis, severe anemia and depression. Nutritional supplementation must be adapted according to its ability to satisfy nutritional needs: oral supplements in patients with beginning undernutrition; intradialytic parental nutrition in patients with severe malnutrition and spontaneous intakes more than 20 kcal/kg/day; daily enteral nutrition when spontaneous intakes are less than 20 kcal/kg/day.
Similar articles
-
The use of intradialytic parenteral nutrition in acutely ill haemodialysed patients.J Ren Care. 2008 Mar;34(1):14-8. doi: 10.1111/j.1755-6686.2008.00005.x. J Ren Care. 2008. PMID: 18336518 Clinical Trial.
-
Intradialytic parenteral nutrition in hemodialysis patients: Acute and chronic intervention.CANNT J. 2006 Apr-Jun;16(2):30-3. CANNT J. 2006. PMID: 16875291
-
[Nutrition and dialysis: how to keep adequate nutrition in dialysis?].Rev Med Suisse Romande. 2004 Nov;124(11):681-8. Rev Med Suisse Romande. 2004. PMID: 15631165 Review. French.
-
Short daily hemodialysis and nutritional status in patients with chronic renal failure.Semin Dial. 2004 Mar-Apr;17(2):104-8. doi: 10.1111/j.0894-0959.2004.17205.x. Semin Dial. 2004. PMID: 15043610
-
[Malnutrition and chronic renal failure].Ann Med Interne (Paris). 2000 Nov;151(7):563-574. Ann Med Interne (Paris). 2000. PMID: 11139657 Review. French.
Publication types
MeSH terms
LinkOut - more resources
Medical
Research Materials