Diätetische Maßnahmen bei Dialysepatienten

Wenn ernährungsmedizinisch relevante Eigenheiten von Patienten mit einer dialysepflichtigen Niereninsuffizienz berücksichtigt werden, bietet die Ernährungsmedizin eine wesentliche und oftmals nicht genügend ausgeschöpfte Möglichkeit, um das Langzeitüberleben an der Dialyse zu verlängern, auf die in Zeiten knapper Spenderorgane mehr eingegangen werden sollte. Eine allzu strenge Adhärenz an einer umfassenden Nahrungsmittelrestriktion, z. B. gegenüber Eiweiß, Phosphat und Kalium, lässt sich durch die aktuelle Datenlage sicher nicht unterstützen, sodass grundsätzlich Fingerspitzengefühl und Augenmaß im Einzelfall vonnöten sind. Auch woran der Erfolg einer ernährungsmedizinischen Intervention gemessen werden sollte, bleibt weiterhin Gegenstand der Forschung.

For patients with end-stage renal disease, nutritional medicine offers an often insufficiently tapped resource to extend the long-term survival on dialysis, which especially in times of scarce donor organs becomes ever more important. Strict undifferentiated adherence to universal restriction of protein, phosphate and potassium is not supported by current data, rather individualized approaches case by case are required. Questions remaining to be answered by controlled studies include for instance how the success of nutritional interventions can better be measured.

Key words

nutrition - dialysis - mortality - survival - smoking - weight

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