Tai T W, Chan A M, Cochran C C, Harbert G, Lindley J, Cotton J
Health Management Department, School of Business, Quinnipiac College, Hamden, CT, USA.
J Ren Nutr. 1998 Oct;8(4):188-98. doi: 10.1016/s1051-2276(98)90017-6.
Determine the prevalence of malnutrition per facility standards; examine interventions used to treat malnutrition; and share experiences, concerns, and solutions to problems in the management of malnutrition in dialysis patients in Texas.
Structured survey questionnaires.
196 outpatient hemodialysis (HD) and 86 peritoneal dialysis (PD) programs in End-Stage Renal Disease (ESRD) Network of Texas, Inc.
Renal dietitians who worked in Texas dialysis facilities that treated chronic, outpatient adult, and pediatric ESRD patients on HD or PD. MEASIRES: Criteria used to identify malnourished patients, prevalence of malnutrition in dialysis recipients, prevalence and types of interventions used to manage malnourished patients, and participation in quality management activities among renal dietitians.
For facilities that treated both HD and PD patients in 1996: (1) a significantly greater proportion of PD patients were identified as malnourished than HD patients; (2) facilities that had a high percentage of malnourished HD patients also had a high percentage of malnourished PD patients; (3) a significantly greater proportion of PD patients received commercial nutrition supplements than HD patients; and (4) use of tube feedings, intradialytic parenteral nutrition, intraperitoneal parenteral nutrition, and total parenteral nutrition among HD and PD patients decreased significantly from the past to the current survey year. Renal dietitians shared their experiences, concerns and solutions to problems in the management of malnutrition in this population.
Results indicate a need to improve the nutritional status of malnourished dialysis patients, to increase consideration of tube feedings as viable nutrient delivery routes, and to maximize involvement of renal dietitians in the quality management process. With the cooperative effort of staff, care givers, patients, and family, early identification and appropriate interventions may improve the nutritional status and quality of life of dialysis patients. This is a US government work. There are no restrictions on its use.
根据机构标准确定营养不良的患病率；检查用于治疗营养不良的干预措施；并分享德克萨斯州透析患者营养不良管理方面的经验、问题及解决方案。
结构化调查问卷。
德克萨斯终末期肾病网络公司的196个门诊血液透析（HD）项目和86个腹膜透析（PD）项目。
在德克萨斯州透析机构工作的肾脏营养师，这些机构为慢性、门诊成年及儿科终末期肾病患者提供HD或PD治疗。
用于识别营养不良患者的标准、透析接受者中营养不良的患病率、用于管理营养不良患者的干预措施的患病率及类型，以及肾脏营养师参与质量管理活动的情况。
对于1996年同时治疗HD和PD患者的机构：（1）被确定为营养不良的PD患者比例显著高于HD患者；（2）营养不良HD患者比例高的机构，营养不良PD患者比例也高；（3）接受商业营养补充剂的PD患者比例显著高于HD患者；（4）从过去到当前调查年份，HD和PD患者中管饲、透析期间胃肠外营养、腹膜内胃肠外营养及全胃肠外营养的使用显著减少。肾脏营养师分享了他们在该人群营养不良管理方面的经验、问题及解决方案。
结果表明需要改善营养不良透析患者的营养状况，更多考虑将管饲作为可行的营养输送途径，并使肾脏营养师最大程度参与质量管理过程。通过工作人员、护理人员、患者及家属的共同努力，早期识别和适当干预可能改善透析患者的营养状况和生活质量。这是美国政府的工作。其使用不受限制。
