Anderson Cheryl A M, Nguyen Hoang Anh
Division of Preventive Medicine, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA.
Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA.
Semin Dial. 2018 Mar;31(2):115-121. doi: 10.1111/sdi.12681. Epub 2018 Feb 18.
Diet counseling and nutrition education are recommended in the prevention and management of chronic kidney disease (CKD) and end-stage renal disease (ESRD). The importance of effectively addressing nutrition with patients has grown given the increasing prevalence of obesity, hypertension, and diabetes; conditions which influence CKD/ESRD. Dietary advice for individuals with CKD/ESRD can be seen as complex; and successful dietary management requires careful planning, periodic assessment of nutritional status, as well as monitoring of dietary compliance. In spite of recommendations and pressing need, formal training in nutrition and adequate preparation for providers is limited; and for physicians the lack of nutrition education has been acknowledged, repeatedly, as an area for improvement in medical training curricula. It has also been suggested that dietitians have an essential role in management of CKD in the primary care setting; however, dietitians who do not practice renal education daily may need training on the specific challenges in CKD/ESRD. The objectives of this chapter were to: characterize select nutrition education resources for providers who care for patients with CKD/ESRD; summarize key dietary components emphasized in the care of patients with CKD/ESRD; and address practical considerations in educational efforts focused on nutrition and CKD/ESRD.
在慢性肾脏病（CKD）和终末期肾病（ESRD）的预防和管理中，建议进行饮食咨询和营养教育。鉴于肥胖、高血压和糖尿病（这些影响CKD/ESRD的疾病）的患病率不断上升，有效解决患者营养问题的重要性日益凸显。针对CKD/ESRD患者的饮食建议可能较为复杂；成功的饮食管理需要精心规划、定期评估营养状况以及监测饮食依从性。尽管有相关建议且需求迫切，但针对医护人员的营养方面的正规培训以及充分准备却很有限；而且医生缺乏营养教育这一问题在医学培训课程中已被多次认定为有待改进的领域。也有人提出，营养师在初级保健环境中对CKD的管理起着至关重要的作用；然而，并非每日从事肾脏疾病教育工作的营养师可能需要接受关于CKD/ESRD特定挑战方面的培训。本章的目的是：描述为照顾CKD/ESRD患者的医护人员提供的特定营养教育资源；总结在CKD/ESRD患者护理中强调的关键饮食成分；并阐述在专注于营养和CKD/ESRD的教育工作中的实际考量因素。
