Kelly Jaimon T, Jegatheesan Dev K, Dawson Jessica, Barnett Amandine, Khor Ban-Hock, Chang Alex R, Carrero Juan-Jesus, Campbell Katrina L
Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.
J Ren Nutr. 2023 Nov;33(6S):S80-S87. doi: 10.1053/j.jrn.2023.02.004. Epub 2023 Mar 24.
People living with chronic kidney disease (CKD) require long-term support at varying levels of individualization, intensity, and frequency. Mobile and digital models of nutrition care can facilitate long-term behavior change, address nutrition issues proactively, reduce travel burden, and reach people without access to health care more easily. However, while traditional health delivery continues to be digitally disrupted, there are many barriers to address before mobile and digitally supported models of nutrition care can become business as usual in nephrology and nutrition care practice. This paper overviews the current evidence base concerning the past and present mobile and digital health programs to improve nutrition in CKD and highlights the novel future trends in this field. The way nutrition and dietetic care can be feasible, safe, and potentially effective when delivered using various digital and virtual technologies, including consultations, assessments, establishment of diagnoses, formulation of plans, and monitoring/reviewing clinical progress is discussed. Of the available evidence to date, these modalities appear to improve dietary sodium intake and diet quality, self-efficacy, interdialytic weight gain, and body weight. Many barriers exist to sustaining the continued and widespread adoption of digital and mobile health-supported nutrition care in CKD. These include patient-, clinician-, and health system-specific and are discussed in detail. Mobile and digital-supported models of nutrition care present an exciting opportunity to assist kidney dietitians deliver patient-centred nutrition care in CKD.
慢性肾脏病（CKD）患者需要长期支持，这种支持在个性化程度、强度和频率上各不相同。移动和数字营养护理模式可以促进长期行为改变，积极解决营养问题，减轻出行负担，并更容易惠及无法获得医疗服务的人群。然而，尽管传统医疗服务持续受到数字化冲击，但在移动和数字支持的营养护理模式能够在肾脏病学和营养护理实践中成为常态之前，仍有许多障碍需要克服。本文概述了有关过去和当前用于改善CKD患者营养状况的移动和数字健康项目的现有证据基础，并突出了该领域未来的新趋势。文中还讨论了使用各种数字和虚拟技术（包括咨询、评估、诊断确立、计划制定以及临床进展监测/复查）提供营养和饮食护理时，如何做到可行、安全且可能有效。就目前可得的证据而言，这些方式似乎能改善饮食中钠的摄入量、饮食质量、自我效能感、透析间期体重增加以及体重。在CKD中持续且广泛采用数字和移动健康支持的营养护理存在诸多障碍。这些障碍包括患者、临床医生以及卫生系统方面的因素，将在文中详细讨论。移动和数字支持的营养护理模式为协助肾脏营养师在CKD中提供以患者为中心的营养护理提供了一个令人兴奋的机会。
