Multifaceted Nutritional Disorders in Elderly Patients Undergoing Dialysis
Multifaceted Nutritional Disorders in Elderly Patients Undergoing Dialysis
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DOI：
10.3390/kidneydial3010001
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发表时间：
2022-12
期刊：
影响因子：
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通讯作者：
K. Mori;Masafumi Kurajoh;M. Inaba;M. Emoto
中科院分区：
文献类型：
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作者：
K. Mori;Masafumi Kurajoh;M. Inaba;M. Emoto
医学的进步导致寿命的延长，从而导致了意想不到的老年综合症，如虚弱和肌肉减少症。终末期肾病患者，特别是接受透析治疗的患者，经常表现出特征性的体内蛋白质和能量储存减少，称为蛋白质能量浪费（PEW）。因此，维持营养状况在预防老年综合征和皮尤方面具有关键作用，这两种症状在接受血液透析的老年人中有几个共同的组成部分。为了防止不良状况的发展，营养评估是必不可少的。除了简单的身体质量指数、血清白蛋白和肌酐的测量外，包括营养不良炎症评分在内的综合营养评估也是有用的，尽管主观因素也包括在内，并且需要训练有素的检查员。另一方面，老年营养风险指数和日本血液透析患者营养风险指数（NRI-JH）是客观的工具，易于临床使用。营养不良与感染事件密切相关，老年患者感染的结果往往很严重，即使是那些存活下来的患者，也需要支付高额的医疗费用。结合适当的营养评估，有必要明确PEW与感染的潜在关系，以改善老年患者的预后。
Advances in medicine have resulted in increased longevity, which has consequently led to unexpected geriatric syndromes, such as frailty and sarcopenia. Patients with end-stage kidney disease, especially those receiving dialysis treatment, often show characteristic reductions in body protein and energy storage, termed protein energy wasting (PEW). Therefore, maintenance of nutritional condition has a key role in defending against both geriatric syndromes and PEW, which share several components in elderly individuals undergoing hemodialysis. To counteract the development of an undesirable condition, nutritional evaluation is indispensable. In addition to simple measurements of body mass index, and serum albumin and creatinine, a composite nutritional assessment including a malnutrition inflammation score is useful, although subjective elements are included and a well-trained examiner is required. On the other hand, the geriatric nutritional risk index and nutritional risk index for Japanese hemodialysis patients (NRI-JH) are objective tools, and easy to use in clinical settings. Undernutrition is closely related to infectious events and the results of an infection are often serious in elderly patients, even those with survival, with large medical costs incurred. Together with appropriate nutritional evaluation, it is necessary to clarify the underlying relationship of PEW with infection for improvement of prognosis in affected elderly individuals.