Cano N, Fiaccadori E, Tesinsky P, Toigo G, Druml W, Kuhlmann M, Mann H, Hörl W H
Residence du parc, Centre Hospitalier Privé, Marseille, France.
Clin Nutr. 2006 Apr;25(2):295-310. doi: 10.1016/j.clnu.2006.01.023. Epub 2006 May 12.
Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility of increasing or ensuring nutrient intake in cases where normal food intake is inadequate. These guidelines are intended to give evidence-based recommendations for the use of ONS and TF in nephrology patients. They were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publications since 1985. They were discussed and accepted in a consensus conference. Because of the nutritional impact of renal diseases, EN is widely used in nephrology practice. Patients with acute renal failure (ARF) and critical illness are characterized by a highly catabolic state and need depurative techniques inducing massive nutrient loss. EN by TF is the preferred route for nutritional support in these patients. EN by means of ONS is the preferred way of refeeding for depleted conservatively treated chronic renal failure patients and dialysis patients. Undernutrition is an independent factor of survival in dialysis patients. ONS was shown to improve nutritional status in this setting. An increase in survival has been recently reported when nutritional status was improved by ONS.
通过口服营养补充剂（ONS）和管饲（TF）进行肠内营养（EN），为在正常食物摄入量不足的情况下增加或确保营养摄入提供了可能。这些指南旨在为肾病患者使用ONS和TF提供循证建议。它们由一个跨学科专家组根据官方认可的标准制定，并基于1985年以来的所有相关出版物。它们在一次共识会议上进行了讨论并获得通过。由于肾脏疾病对营养的影响，EN在肾病实践中被广泛使用。急性肾衰竭（ARF）和危重症患者的特点是处于高分解代谢状态，需要采用诱导大量营养物质流失的净化技术。对于这些患者，通过TF进行EN是营养支持的首选途径。对于保守治疗的慢性肾衰竭患者和透析患者，通过ONS进行EN是重新喂养的首选方式。营养不良是透析患者生存的一个独立因素。在这种情况下，ONS已被证明可改善营养状况。最近有报道称，通过ONS改善营养状况可提高生存率。
