慢性肾病患者营养状况的特点

Q4 Medicine Meditsinskiy Sovet Pub Date : 2023-11-04 DOI:10.21518/ms2023-392
S. V. Tishkina, V. S. Shemenkova, E. V. Konstantinova
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引用次数: 0

摘要

慢性肾脏疾病是在多种病因的作用下,持续三个月以上的肾脏损害,其解剖学基础是正常解剖结构被纤维化取代的过程,导致其功能障碍。这种疾病分类学在现代世界很常见;它可以发展并导致患者残疾,并降低他们的生活质量。这种疾病的死亡率也很高。约有3/4的患者有终末期病程,其特点是发展为蛋白质能量缺乏(由于尿毒症、营养不良、酸中毒和持续的炎症过程),这明显恶化了预后。目前已有的文献中针对这一问题的研究较少,因此对慢性肾病患者(特别是血液透析患者)的营养状况进行评估和纠正是其管理的重要组成部分。本文就蛋白质能量营养不良的发展、可能的诊断和纠正方法等方面作一综述。电解质紊乱,特别是高钾血症和高磷血症,也是慢性肾脏疾病的常见并发症。纠正这些情况反过来又会导致维生素和其他微量元素的缺乏。根据文献研究,营养状况是决定肾替代治疗患者生存和康复程度的主要因素之一,也是决定透析治疗效果的主要因素之一。因此,临床医生了解这组患者的营养状况可以改善他们的预后和生活质量。
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Characteristics of nutritional status in patients with chronic kidney disease
Chronic kidney disease is kidney damage that persists for three months or more due to the action of various etiological factors, the anatomical basis of which is the process of replacement of normal anatomical structures with fibrosis, leading to its dysfunction. This nosology is quite common in the modern world; it can progress and lead to disability of patients and a decrease in their quality of life. The mortality rate for this disease also remains high. About 3/4 of patients with this pathology have a terminal stage of the process, which is characterized by the development of protein-energy deficiency (due to uremia, malnutrition, acidosis and persistent inflammatory process), which significantly worsens the prognosis. Currently, the available literature contains a small number of works devoted to this problem, therefore an important part of the management of patients with chronic kidney disease (especially those on hemodialysis) is the assessment and correction of nutritional status. In this article, the authors highlight aspects of the development of protein-energy malnutrition, its possible methods of diagnosis and correction. Electrolyte disturbances, especially hyperkalemia and hyperphosphatemia, are also common complications of chronic kidney disease. Correction of these conditions, in turn, can lead to the development of deficiency of vitamins and other microelements. According to studies presented in the literature, nutritional status is one of the main factors determining the survival and degree of rehabilitation of patients on renal replacement therapy, as well as the effectiveness of dialysis treatment. Thus, a clinician’s knowledge of the nutritional status of this group of patients can improve their prognosis and quality of life.
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来源期刊
Meditsinskiy Sovet
Meditsinskiy Sovet Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
418
审稿时长
6 weeks
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