[1]王 洁,许惠仙.行CRRT的AKI病人营养支持治疗研究进展[J].肠外与肠内营养杂志,2021,(04):247-252.[doi:10.16151/j.1007-810x.2021.04.012]
　WANG Jie,XU Hui-xian.Research progress of nutritional support therapy for AKI patients undergoing CRRT[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):247-252.[doi:10.16151/j.1007-810x.2021.04.012]
点击复制

行CRRT的AKI病人营养支持治疗研究进展
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年04期
页码:
247-252
栏目:
综述
出版日期:
2021-07-10

文章信息/Info

Title:
Research progress of nutritional support therapy for AKI patients undergoing CRRT
作者:
王 洁; 许惠仙
延边大学附属医院临床营养科，吉林延吉 133000
Author(s):
WANG Jie;  XU Hui-xian
Department of Clinical Nutrition, Yanbian University Hospital, Yanji 133000, Jilin, China
关键词:
连续性肾脏替代治疗 ; 急性肾损伤 ; 营养支持
Keywords:
Continuous renal replacement therapy;  Acute kidney injury;  Nutritional support
分类号:
R692
DOI:
10.16151/j.1007-810x.2021.04.012
文献标志码:
A
摘要:
危重症病人常出现急性肾损伤(AKI)，连续性肾脏替代治疗(CRRT)具有对循环系统影响小，维持内环 境的稳定，确保营养支持，可实现床旁治疗等优点，AKI病人常合并糖类、脂肪、蛋白质代谢异常，水、电解质紊乱和 酸碱平衡失调，需要特别注意 CRRT对能量、三大营养物质、微营养素的影响，因为这关系到此类病人营养治疗策略 和治疗效果。本文综述 CRRT对危重症 AKI病人能量和营养素的影响以及如何对行 CRRT的危重症 AKI病人进行 营养干预。
Abstract:
Acute kidney injury is common in critically ill patients, and continuous renal replacement therapy has the advantages of little impact on the circulation system, maintaining the stability of the internal environment, ensuring nutritional support, realizing bedside treatment. Patients with acute kidney injury often suffer from abnormal metabolism of sugar, fat and protein, disturbance of water-electrolyte and imbalance of acid-base balance, special attention needs to be paid to the effects of CRRT on energy, three-nutrients and micronutrients, as it is related to the strategy and effectiveness of nutritional treatment in these patients. This research mainly describes the influences of CRRT on energy and nutrients, and how to conduct nutritional intervention in critically ill AKI patients undergoing CRRT.

参考文献/References:


[1] 许 媛 . 急性肾损伤患者怎样做到恰当的营养支持 .中华重症医学电子杂志(网络版), 2018, 4(1):17-21.
[2] Nystrom EM, Nei AM. Metabolic Support of the Patient on Continuous Renal Replacement Therapy. Nutr Clin Pract, 2018,33(6):754-766.
[3] 肖亚娟, 许 磊 . 早期肠内营养对 ICU中实施连续肾脏替代疗法患者的效果分析 .中国血液净化, 2019,18(5):308-311.
[4] Schneider A. Acute Kidney Injury With and Without Renal Replacement Therapy. Critical Care Nutrition Therapy for Nonnutritionists.2018: 99-109.
[5] 江荣林 . CRRT时,如何实施营养支持?. 首届西湖国际血液净化论坛论文汇编 . 浙江省医学会重症医学分会:浙江省科学技术协会, 2015: 12.
[6] Wiesen P, Van Overmeire L, Delanaye P, et al. Nutrition disorders during acute renal failure and renal replacement therapy. JPEN J Parenter Enteral Nutr, 2011, 35(2):217-222.
[7] Honoré PM, De Waele E, Jacobs R, et al. Nutritional and metabolic alterations during continuous renal replacement therapy. Blood Purif, 2013, 35(4):279-284.
[8] New AM, Nystrom EM, Frazee E, et al. Continuous renal replacement therapy: a potential source of calories in the critically ill. Am J Clin Nutr, 2017, 105(6):1559-1563.
[9] 王海霞, 朱 曦, 么改琦 . 急性肾衰竭患者进行连续性肾脏替代治疗时的氨基酸补充 .中国血液净化, 2009, 8(11):622-625.
[10] Onichimowski D, Goraj R, Jalali R, et al. Practical issues of nutrition during continuous renal replacement therapy. Anaesthesiol Intensive Ther, 2017, 49(4):309-316.
[11] 张凯悦, 龚德华, 徐 斌, 等 .不同剂量和模式连续性肾脏替代治疗对氨基酸的清除 .肾脏病与透析肾移植杂志, 2012, 21(3):223-227.
[12] 张雪梅, 张 凌, 付 平 . 连续性肾脏替代治疗患者微量营养元素及电解质的丢失与补充 . 中华内科杂志, 2014, 53(3):224-227.
[13] Ben-Hamouda N, M Charrière , Voirol P, et al. Massive copper and selenium losses cause life-threatening deficiencies during prolonged continuous renal replacement. Nutrition, 2017, 34:71-75.
[14] Berger MM, Broman M, Forni L, et al. Nutrients and micronutrients at risk during renal replacement therapy: a scoping review. Curr Opin Crit Care, 2021, 27(4): 367-377.
[15] 杭 成 . 连续静-静脉血液滤过与透析滤过模式对重症患者溶质清除效率及滤器寿命的比较研究 . 苏州大学, 2019.
[16] Fiaccadori E, Sabatino A, Barazzoni R, et al. ESPEN guideline on clinical nutrition in hospitalized patients with acute or chronic kidney disease. Clin Nutr, 2021, 40(4): 1644-1668.
[17] McClave S A, Taylor B E, Martindale R G, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN. Journal of parenteral and enteral nutrition, 2016, 40(2): 159-211.
[18] Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
[19] Canales C, Elsayes A, Yeh DD, et al. Nutrition risk in critically ill versus the nutritional risk screening 2002: are they comparable for assessing risk of malnutrition in critically ill patients?. JPEN J Parenter Enteral Nutr, 2019, 43(1): 81-87.
[20] Machado dos Reis A, Marchetti J, Forte dos Santos A, et al. NUTRIC Score: isolated and combined use with the NRS‐2002 to predict hospital mortality in critically ill patients. JPEN J Parenter Enteral Nutr, 2020, 44(7): 1250-1256.
[21] Maciel LRMA , Franzosi OS, Nunes DSL, et al. Nutritional risk screening 2002 cut-off to identify high-risk is a good predictor of ICU mortality in critically ill patients. Nutr Clin Pract, 2019, 34(1): 137-141.
[22] Li C, Xu L, Guan C, et al. Malnutrition screening and acute kidney injury in hospitalised patients: a retrospective study over a 5-year period from China. Br J Nutr, 2020, 123(3): 337-346.
[23] Khor BH, Tiong HC, Tan SC, et al. Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis. Nutrients, 2020, 12(9): 2809.
[24] Xia YA, Healy A, Kruger R. Developing and validating a renal nutrition screening tool to effectively identify undernutrition risk among renal inpatients. J Ren Nutr, 2016, 26(5): 299-307.
[25] Reintam Blaser A, Starkopf J, Alhazzani W, et al. Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med, 2017, 43(3):380-398.
[26] 刘莲琴, 张卫东, 缑 楠 . 维持性血液透析联合肠内营养改善透析患者营养状况的观察 . 检验医学与临床, 2020,17(14):2070-2072.
[27] 江荣林 . 危重症患者的营养治疗策略 . 实用休克杂志, 2019, 3(4):198- 200.
[28] 黄健平 . 连续性肾替代治疗肾衰竭患者肠外营养支持时机的选择 . 国际泌尿系统杂志, 2016, 36(2):240-242.
[29] 戴正青,陈红梅 . 肠内加肠外营养支持在危重病患者中的合理应用观察 . 医学食疗与健康, 2020, 18(17):8,13.
[30] 刘 斌,宾文凯,陈小梅,等 . 肠内营养与肠外营养对危重症临床疗效的 Meta分析 . 肠外与肠内营养,2017,24(5):277-282.
[31] 王 芳, 姚志清, 陈 璐, 等 . 早期低热卡肠内营养支持在危重症病人中应用效果的 Meta分析 .护理研究, 2019,33(5):748-753.
[32] Dey R. Protein delivery in critical care. Journal of Renal Nutrition and Metabolism, 2019, 5(1): 12.
[33] Patkova A, Joskova V, Havel E, et al. Energy, protein, carbohydrate, and lipid intakes and their effects on morbidity and mortality in critically ill adult patients: a systematic review. Adv Nutr, 2017, 8(4): 624-634.
[34] Arabi YM, Aldawood AS, Al-Dorzi HM, et al. Permissive underfeeding or standard enteral feeding in high – and low –nutritional-risk critically ill adults. Post hoc analysis of the PermiT trial. American journal of respiratory and critical care medicine, 2017, 195(5): 652-662.
[35] Boot R, Koekkoek KWAC , van Zanten ARH. Refeeding syndrome: relevance for the critically ill patient. Curr Opin Crit Care, 2018, 24(4):235-240.
[36] 魏 萌, 吴允孚 . 再喂养综合征的研究进展 . 肠外与肠内营养,2020,27(4):243-247.
[37] Mehta H. Why is acute kidney injury more demanding in terms of nutritional support?. Journal of Renal Nutrition and Metabolism, 2019, 5(1): 28.
[38] J Echeverri , Molano A. Ajuste de fármacos y nutrición enterapias de reemplazo renal continuo. Gac Med Mex, 2018, 154(Supp 1): S48-S60.
[39] Ostermann M, Lumlertgul N, Mehta R. Nutritional assessment and support during continuous renal replacement therapy. Seminars Dial, 2021.
[40] Wu B, Ji D, Xu B, et al. New modes of continuous renal replacement therapy using a refiltering technique to reduce micronutrient loss: CRRT modes reduce micronutrient loss. Hemodial Int, 2019, 23(2): 181-188.
[41] Besnard N, Serveaux M, Machado S, et al. Electrolytes-Enriched Hemodiafiltration Solutions for Continuous Renal Replacement Therapy in Acute Kidney Injury: A Crossover Study. Blood Purif,2016, 42(1):18-26.
[42] Yessayan L, Yee J, Frinak S, et al. Continuous Renal Replacement Therapy for the Management of Acid-Base and Electrolyte Imbalances in Acute Kidney Injury. Adv Chronic Kidney Dis, 2016, 23(3):203-210.
[43] Pistolesi V, Zeppilli L, F Polistena , et al. Preventing Continuous Renal Replacement Therapy-Induced Hypophosphatemia: An Extended Clinical Experience with a Phosphate-Containing Solution in the Setting of Regional Citrate Anticoagulation. Blood Purif, 2017, 44(1):8-15.
[44] Pistolesi V, Zeppilli L, Fiaccadori E, et al. Hypophosphatemia in critically ill patients with acute kidney injury on renal replacement therapies. J Nephrol, 2019, 32(6): 895-908.
[45] Di Mario F, Regolisti G, Greco P, et al. Prevention of hypomagnesemia in critically ill patients with acute kidney injury on continuous kidney replacement therapy: the role of early supplementation and close monitoring. J Nephrol, 2020.
[46] Schneider AG, Picard W, PM Honoré , et al. Amino acids and vitamins status during continuous renal replacement therapy: an ancillary prospective observational study of a randomised control trial. Anaesth Crit Care Pain Med, 2021, 40(2):100813.
[47] Datzmann T, Tr?ger K, Schr?ppel B, et al. Treatment dose and the elimination rates of electrolytes, vitamins, and trace elements during continuous veno-venous hemodialysis (CVVHD). Int Urol Nephrol, 2018, 50(6): 1143-1149.

相似文献/References:

[1]段光辉,田 运,王海霖,等.早期行CRRT治疗肠外瘘致腹腔感染并发AKI的疗效观察[J].肠外与肠内营养杂志,2020,(02):72.[doi:10.16151/j.1007-810x.2020.02.003]
　DUAN Guang-hui,TIAN Yun,WANG Hai-lin,et al.Early CRRT treatment of intra-abdominal infection complicated with AKI[J].PARENTERAL & ENTERAL NUTRITION,2020,(04):72.[doi:10.16151/j.1007-810x.2020.02.003]

备注/Memo

备注/Memo:
基金项目 ：延边大学应用基础项目（延大科合字2019第36号） 作者简介 ：王 洁，医学硕士研究生，从事急诊医学研究。E-mail：346300941@qq.com 通讯作者 ：许惠仙，E-mail：huixianxu@sina.com
更新日期/Last Update: 1900-01-01