Significance of Continuous Nutritional Guidance for Long-term Maintenance Hemodialysis Patients

DOI 13 References
  • ISHIKAWA Yuichi
    Nutrition department, Hitachi General Hospital:Environmental Symbiotic Studies, Graduate School, Tokyo University of Agriculture
  • SAITO Chie
    Department of Nephrology, Faculty of Medicine University of Tsukuba
  • NAKAGAWA Yukie
    Department of Nutrition, Sapporo Social Insurance General Hospital
  • KASHIMURA Osamu
    Faculty of International Agriculture and Food Studies, Tokyo University of Agriculture
  • YAMAGATA Kunihiro
    Department of Nephrology, Faculty of Medicine University of Tsukuba

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  • 長期透析患者に対する継続的栄養指導の効果

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The number of maintenance hemodialysis patients in Japan has been increasing every year, and as a result the phenomena such as increasing long-term hemodialysis patients and aging of such patients have become a problem. Long-term hemodialysis patients and aging of such patients have become a problem. It is important for maintenance hemodialysis patients to have nutritional management in order to receive an appropriate dialysis treatment. Since hyperpotassium, hyperphosphatemia, water, and salt have close relationship with meal consumption, emphasis is to be put on nutritional guidance. Therefore, this study was examined the effect of continuous nutritional and dietary guidance to maintenance hemodialysis. The subjects were 16 hemodialysis patients (7 males and 9 females) who had been given continuous nutritional and dietary guidance for more than 10 years since 2000, and conducted guidance once or more times a month. We studiet their weight increase ratio during dialysis and values in blood test. If we compared in 2000 with in 2009, weight increase ratio during dialysis, serum potassium level. Were not seen significant difference. This suggests that continuous nutritional guidance maintained the level within the standard value and the level was properly controlled. However, serum albumin level decreased significantly in 2009. When we examined the influence factors for the change of serum albumin, serum phosphate level, serum potassium level and weight increase during dialysis are suggestion possibly rated to decrease of serum albumin. Since serum albumin concentration has directly related to the vital prognosis of maintenance hemodialysis patients, it is considered that not only the limitation of phosphate and potassium from meals, but also the comprehensive guidance focusing on medication therapy and dialysis conditions is effective. In this study, according to the index that is influenced diet was controlledwithin the management value, there had effect of nutritional and dietary guidance. But serum albumin that is one of nutritional conditions marker was not controlled. Henceforth, we can considered that it is necessary that the comprehensive nutritional maintenance focusing on medication and dialysis conditions in nutritional and dietary guidance.

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