血液透析患者之營養評估

Nutritional Assessment for Hemodialysis Patients

蛋白質－－熱量營養不良常見於血液透析患者，定期評估和監測蛋白質與熱量營養狀態對避免、診斷和治療蛋白質－－熱量營養不良是很重要的。蛋白質－－熱量營養不良也和血液透析患者的罹病率和死亡率增加有強烈之相關性。美國國家腎臟基金會提出營養臨床實用指引，對血液透析患者營養評估提出建議。因為無法使用單一測量方法去完整評估患者之蛋白質與熱量營養狀態，故本文將一些有效的指標在整體評估上之角色略作敘述，亦提出對血液透析患者剛開始血液透析、一個月追蹤和每六個月追蹤之營養評估項目之建議。

Protein-energy malnutrition (PEM) is very common in patients undergoing maintenance hemodialysis (MHD). Routine assessment and monitoring of protein and energy nutritional status is crucial to prevent, diagnose and treat PEM. PEM is strongly correlated with increased morbidity and mortality in MHD patients. The NKF-K/DOQI Nutrition Clinical Practice Guidelines provide recommendations regarding the nutritional assessment of protein-energy nutritional status for MHD patients. However, no single measure provides a complete overview of protein -energy nutritional status. Each of the valid indicators described in the text has a role in the overall nutritional assessment of dialysis patients. Initial, one-month follow-up nutrition assessment and nutritional updates every six months are recommended for MHD patients.