PROCJENA NUTRICIJSKOG STATUSA U BOLESNIKA S KRONIČNOM BUBREŽNOM BOLESTI KOJI SE LIJEČE REDOVITOM HEMODIJALIZOM

Prema definiciji Svjetske zdravstvene organizacije (engl. Word Health Organization WHO) malnutricija označava stanje nedovoljnog ili čak odsutnog unosa proteina, energije i mikronutrijenata, kao što su to vitamini, minerali, oligoelementi i elementi u tragovima, što dovodi do veće sklonosti infekcijama, povećanja mortaliteta i smanjenja kvalitete života. Navedena definicija reflektira proteinsko-kalorijski manjak koji se oporavlja s nadoknadom nutritijenata koji nedostaju. U kontekstu kronične bubrežne bolesti (KBB) koristi se termin proteinsko-energetski gubitak (engl. Pretein-Energy Wasting; PEW) koji obuhvaća smanjene proteinske i energetske komponente u tijelu (tjelesnih proteina i masti). Procjena nutritivnog statusa je integralni dio skrbi o bolesnicima s KBB, osobito onih koji se liječe postupcima dijalize. Naime, prema dostupnoj literaturi 18 % do 80 % bolesnika na dijalizi ima neki oblik nutritivnog deficita (1-4). U tih bolesnika dolazi do gubitka kako mišićne mase, tako i ukupnih tjelesnih masti. U bolesnika koji se liječe postupcima dijalize ne smijemo zaboraviti pravilo tzv. "obrnute epidemiologije”, odnosno bolesnici s boljim nutritivnim statusom imaju bolje preživljenje. Nadalje, poznato je da neki od parametara nutritivnog statusa, kao npr. vrijednosti serumskih albumina koreliraju s preživljenjem ove populacije bolesnika. Prema preporukama DOQI (engl, Dialysis Outcome Quality Initiative) neophodna je redovita procjena nutritivnog statusa bolesnika koji se liječe redovitom hemodijalizom (HD) u cilju sprječavanja i liječenja nutritivnog manjka. Postoje brojne PROCJENA NUTRICIJSKOG STATUSA U BOLESNIKA S KRONIČNOM BUBREŽNOM BOLESTI KOJI SE LIJEČE REDOVITOM HEMODIJALIZOM

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