老年慢性腎臟病患者的營養照護

Nutritional Problems in Elderly Patients with Chronic Kidney Disease

10.6340/KD.2016.28(3).05

陳昶旭(Chang-Hsu Chen)；林柏松(Paik-Seong Lim)

老年族群 ； 慢性腎臟病 ； 蛋白質能量耗損 ； 營養介入治療 ； geriatric ； chronic kidney disease ； protein-energy wasting ； nutritional intervention

腎臟與透析

28卷3期（2016 / 09 / 01）

125 - 129

繁體中文

老年慢性腎臟病患者因營養問題而常出現身體蛋白質減少的現象，稱為蛋白質能量耗損，進而造成患者失能、生活品質惡化及預後不良。在預防及治療上，需要整合性的營養照護策略，包含定期篩檢、評估、營養介入治療及監測。營養篩檢及評估工具可依其可行性及限制性來選擇。營養介入治療包含多面向的方針，如口服及靜脈營養補充、足量透析、矯正酸血症、運動等等。目前仍待大型研究來發展出屬於老年慢性腎臟病患者的營養治療指引。

The elderly patients with chronic kidney disease (CKD) are prone to suffer from nutritional problem with loss of body protein mass, now called protein-energy wasting (PEW). PEW in elderly CKD is associated with disability, worsened quality of life and poor prognosis. To prevent and treat PEW, a complementary nutritional management process has been proposed, including periodic screening, assessment, nutritional intervention and monitor. The use of nutritional screening and assessment tools needs to be considered the feasibility and limitation. Nutritional intervention consists of multidimensional strategies, such as enteral and parenteral nutrition supplement, adequate dialysis, correction of acidemia, exercise, etc. More large clinical trials are needed to develop guideline for nutritional care specific to elderly CKD patients.