Malnutrition is an important factor in predicting poor prognosis in dialysis patients

How do? Malnutrition is an important factor in predicting poor prognosis in dialysis patients, recent research has made great progress. The following are reviewed on the problem of malnutrition in dialysis patients.

Reason 1 malnourished dialysis patients
Dialysis patients, malnutrition is the result of the interaction of a variety of reasons.
1.1 protein and energy intake deficiency: a lack of protein and energy intake is the main cause of malnutrition in dialysis patients. The study found that the increase in hemodialysis and peritoneal dialysis patients' needs for protein and energy. However, many dialysis patients before dialysis because temporary anorexia or artificially lower protein diet caused reduction in protein and energy intake, which at the start of dialysis there is severe malnutrition. Some reports have found that the incidence of malnutrition at the start of dialysis up to 70. Many reasons anorexia, inadequate dialysis can cause loss of appetite; dialysis patients may also occur due to decreased gastric emptying capacity satiety; dialysis itself cause patient discomfort can also cause loss of appetite.

Other factors, such as drugs, exercise less, loneliness, depression and poverty can cause reduced food intake, especially in elderly patients represent more prominent. Recent studies have found that leptin may be involved in the occurrence of malnutrition in dialysis patients.

1.2 Endocrine disorders: uremia can cause endocrine disorders, which affect the metabolism of protein and glucose, such as insulin resistance, growth hormone and insulin-like growth factor -1IGF-1 resistance. At the same time, promote the decomposition of the secretion of hormones such as glucagon, parathyroid hormone, etc. increase.

1.3 Dialysis lost protein and amino acids: foreign reports, peritoneal dialysis patients in dialysis is usually lost 515g 1.24g of protein and amino acids every day, of which about 30 essential amino acids. When the merger peritonitis, after the loss of the amount of protein increases the peritoneal dialysate 50100 and continues to rise for several weeks. Hemodialysis patients during each dialysis fluid lost by dialysis 58g free amino acids, of which one-third of the essential amino acids, amino acid peptide binding missing 45g total amino acids that each dialysis for lost time with a high-flux dialyzers 1013g, the amount of protein and amino acid loss can be greatly increased.

However, recent studies have found that the country daily peritoneal dialysis patients from dialysate protein loss lower than the foreign reports, the average daily 5g protein loss occurred and that this is not related to malnutrition in peritoneal dialysis patients, it is worth further study.