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Metabolische Führung und Ernährung von Intensivpatienten mit renaler Dysfunktion
- Source :
- Medizinische Klinik - Intensivmedizin und Notfallmedizin. 113:393-400
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Background Intensive care patients with renal failure or insufficiency comprise a heterogeneous group of subjects with widely differing metabolic patterns and nutritional requirements. They include subjects with various stages of acute kidney injury (AKI), acute-on-chronic renal failure (A-CKD), without/with renal replacement therapy (RRT), chronic kidney disease (CKD), and subjects on regular hemodialysis or peritoneal dialysis therapy (HD/PD). Goals Development of recommendations by the renal section of DGIIN (Deutsche Gesellschaft fur Internistische Intensivmedizin und Notfallmedizin), OGIAIN (Osterreichische Gesellschaft fur Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutsche Interdisziplinare Vereinigung fur Intensiv- und Notfallmedizin) for the metabolic management and the planning, indication, implementation, and monitoring of nutrition therapy in this heterogeneous group of patients. Materials and methods The recommendations are based on recent evidence and current recommendations of DGEM (Deutsche Gesellschaft fur Ernahrungsmedizin), ASPEN (American Society for Parenteral and Enteral Nutrition) and ESPEN (European Society for Clinical Nutrition and Metabolism) and also the KDGIO (Kidney Disease: Improving Global Outcomes) clinical practice guidelines for AKI and the expert knowledge and clinical experience of the authors. Results Nutrition support in these patient groups is not fundamentally different from that in other disease states but must consider the multiple variations in metabolism and nutrient requirements. Nutrition therapy must be adapted to the stage of disease and especially, in those patients on RRT. Nutritional needs can differ widely between patients but also in the same patient during the course of the disease. Conclusions Thus, the patient with renal failure requires an individualized approach in nutrition support and because of the altered metabolism of many nutrients and intolerances for electrolytes and fluids, the nutrition support in patients with renal insufficiency requires close clinical and laboratory monitoring.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Acute kidney injury
030208 emergency & critical care medicine
Clinical nutrition
Emergency Nursing
Critical Care and Intensive Care Medicine
medicine.disease
03 medical and health sciences
0302 clinical medicine
Intolerances
Intensive care
Emergency Medicine
Internal Medicine
Medicine
030212 general & internal medicine
Renal replacement therapy
Medical nutrition therapy
Hemodialysis
business
Intensive care medicine
Kidney disease
Subjects
Details
- ISSN :
- 21936226 and 21936218
- Volume :
- 113
- Database :
- OpenAIRE
- Journal :
- Medizinische Klinik - Intensivmedizin und Notfallmedizin
- Accession number :
- edsair.doi...........718904454617f5f7aae4d0f365185b88