接受减肥手术的慢性肾病患者的营养管理:病例报告。

Clinical nutrition research Pub Date : 2024-10-24 eCollection Date: 2024-10-01 DOI:10.7762/cnr.2024.13.4.238
Yunjung Choi, Jiyoung Song, Jeong Hyun Lim, Dal Lae Ju
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引用次数: 0

摘要

营养支持是减肥手术(BS)后治疗的一个重要方面。建议采用高蛋白饮食,每天每公斤理想体重(IBW)最多摄入 1.5 克蛋白质,以尽量减少减肥手术后瘦体重的减少。然而,对于肾功能受损的患者,蛋白质摄入量建议可能需要调整,这就需要根据每位患者的临床状况采取个体化的方法。本病例报告旨在展示一名男性慢性肾脏病(CKD)患者的营养评估、教育和咨询,该患者在术后一年接受了 BS。BS 术后,该患者遵守首尔国立大学医院的标准 BS 饮食方案。考虑到他术后的肾功能,蛋白质需求量被设定为每千克 IBW 1.0 克。根据肾功能和并发症情况,共进行了 10 次个体化营养咨询。BS 一年后,他成功地减轻了体重,超重率达 93%,维持了 CKD 3 期,减少了口服降糖药的处方,改善了糖化血红蛋白水平,饮食习惯也明显改善。因此,个体化营养干预对于支持 CKD 患者在 BS 后达到目标体重、改善营养状况和预防术后并发症非常重要。
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Nutritional Management for Chronic Kidney Disease Undergoing Bariatric Surgery: A Case Report.

Nutrition support is an essential aspect of treatment after bariatric surgery (BS). A high-protein diet with an intake of up to 1.5 g/kg of ideal body weight (IBW) per day is recommended to minimize loss of lean body mass after BS. However, protein intake recommendations may need to be adjusted for patients with compromised renal function, necessitating an individualized approach tailored to each patient's clinical status. This case report aimed to demonstrate nutritional evaluation, education, and counseling for a male patient with chronic kidney disease (CKD) who underwent BS one year after surgery. Following BS, the patient adhered to the standard Seoul National University Hospital BS diet protocol. Considering his postoperative renal function, protein requirement was set at 1.0 g/kg of IBW. A total of 10 individualized nutritional counseling sessions were conducted according to renal function and complications. One year after BS, he successfully lost weight with % excess weight loss of 93%, maintained CKD stage 3, reduced prescription of oral hypoglycemic agent, improved glycated hemoglobin levels, and improved eating habits significantly. Thus, individualized nutrition intervention is important for supporting patients with CKD to reach their goal weight after BS, improve nutritional status, and prevent post-operative complications.

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