Ripon Md Sajjadul Haque, Ahmed Shakil, Rahman Tanjina, Rashid Harun-Ur, Karupaiah Tilakavati, Khosla Pramod, Daud Zulfitri Azuan Mat, Arefin Shakib Uz Zaman, Osmani Abdus Salam
Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Sonapur, Noakhali, Bangladesh.
Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh.
PLoS One. 2023 Sep 21;18(9):e0291830. doi: 10.1371/journal.pone.0291830. eCollection 2023.
Hemodialysis (HD) is a treatment for ensuring the survival of end-stage kidney disease (ESKD) patients, and nutrition care is integral to their management. We sent questionnaires to evaluate the total dialysis service capacity and nutrition services across all dialysis facilities (DF) in Bangladesh, with responses from 149 out of 166 active DFs. Survey results revealed that 49.7% of DFs operated two shifts, and 42.3% operated three shifts daily, with 74.5% holding between one and ten dialysis machines. Sixty-three percent of DFs served between one and 25 patients per week, and 77% of patients received twice-weekly dialysis. The average cost for first-time dialysis was 2800 BDT per session (range: 2500-3000 BDT), but it was lower if reused dialyzers were used (2100 BDT, range: 1700-2800 BDT). Nutritionists were available in only 21% of the DFs. Parameters related to nutritional health screening (serum albumin, BMI, MIS-malnutrition inflammation assessment, and dietary intakes) were carried out in 37.6%, 23.5%, 2%, and 2% of the DFs, respectively, only if recommended by physicians. Nutrition education, if recommended, was provided in 68.5% of DFs, but only in 17.6% of them were these delivered by nutritionists. The recommendation for using renal-specific oral nutrition supplements (ONS) is not a familiar practice in Bangladeshi DFs and, therefore, was scarcely recommended. Dialysis capacity across Bangladesh is inadequate to meet current or projected needs and nutrition education and support across the DFs to benefit improving patients' quality of life is also inadequate.
血液透析（HD）是确保终末期肾病（ESKD）患者生存的一种治疗方法，营养护理是其管理的重要组成部分。我们发放问卷以评估孟加拉国所有透析机构（DF）的总体透析服务能力和营养服务情况，166家活跃的DF中有149家回复了问卷。调查结果显示，49.7%的DF实行两班制，42.3%实行三班制，74.5%拥有1至10台透析机。63%的DF每周为1至25名患者提供服务，77%的患者接受每周两次的透析。首次透析的平均费用为每次2800孟加拉塔卡（范围：2500 - 3000孟加拉塔卡），但如果使用复用透析器，费用会更低（2100孟加拉塔卡，范围：1700 - 2800孟加拉塔卡）。只有21%的DF有营养师。仅在医生建议下，分别有37.6%、23.5%、2%和2%的DF进行了与营养健康筛查相关的参数（血清白蛋白、体重指数、MIS - 营养不良炎症评估和饮食摄入量）检测。如果有建议，68.5%的DF提供了营养教育，但其中只有17.6%是由营养师提供的。在孟加拉国的DF中，使用肾专用口服营养补充剂（ONS）的建议并不常见，因此很少被推荐。孟加拉国的透析能力不足以满足当前或预计的需求，而且各DF在营养教育和支持方面也不足，难以改善患者的生活质量。
