Bossola Maurizio, Muscaritoli Maurizio, Tazza Luigi, Giungi Stefania, Tortorelli Antonio, Rossi Fanelli Filippo, Luciani Giovanna
Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Rome, Italy.
Am J Kidney Dis. 2005 Sep;46(3):371-86. doi: 10.1053/j.ajkd.2005.05.031.
Malnutrition is common in hemodialysis patients and is a powerful predictor of morbidity and mortality. Although much progress has been made in recent years in identifying the causes and pathogenesis of malnutrition in hemodialysis patients, as well as recognizing the link between malnutrition and morbidity and mortality, no consensus has been reached concerning its management. Along with such conventional interventions as nutritional counseling, oral nutritional supplements, and intradialytic parenteral nutrition, novel preventive and therapeutic strategies have been tested, such as appetite stimulants, growth hormone, androgenic anabolic steroids, and anti-inflammatory drugs, with contradictory and nonconclusive results. Malnutrition still remains a great challenge for nephrologists in the third millennium.
营养不良在血液透析患者中很常见，并且是发病率和死亡率的有力预测指标。尽管近年来在确定血液透析患者营养不良的原因和发病机制，以及认识营养不良与发病率和死亡率之间的联系方面取得了很大进展，但在其管理方面尚未达成共识。除了营养咨询、口服营养补充剂和透析期间肠外营养等传统干预措施外，还测试了诸如食欲刺激剂、生长激素、雄激素合成代谢类固醇和抗炎药物等新型预防和治疗策略，但结果相互矛盾且无定论。在第三个千年，营养不良对肾病学家来说仍然是一个巨大的挑战。
