75% [2] 4 10% B6 [3] 70% [4] [5]

Transcription

1 [1] ( ) ( ) RRF (residual renal function) 94% [6] [2] (ESRD) 30 50% 75% [2] 4 10% B6 [3] GB (gastrostomy button) 70% [4] [5]

2 [7] cisapride, metoclopramid, domperidone H2 (cimetidine, ranitidine) (omeprazole) 24 ( ) [6] mg 10% 50 Nelson 100% [8] Stover ( 1) ( ) C B6 (carnitine) [9] ( 2) [10] (indirect calorimetry) (resting energy expenditure) 80% ( 2)

3 1. (1994 ) (kcal/kg) (0 1 ) (1 3 ) (4 10 ) (11 18 ) (g/kg) (mmol/kg) (mmol/kg) (mg) (mg) ml C B C B 1 mg 1 mg 1 mg 1 mg D D 10 mg B6 60 mg C 10 mg B6 10 mg B6 5 mg 10 mg 1 mg B1 1.5 mg B1 1.2 mg 1.7 mg 15 mg 20 mg 3 ug B ug H 6 ug B ug H D D 2. ( ) (kcal/day)

4 ( ) 60 70% [9] K 3. D ( ) 1. C C C 100 mg [12] K K B6 B6 B6 B12 B12 ( H2 ) B6 B12 (hyperhomocysteinemia) [11] 2. A A A E E 80% D D 2 kcal/ml (60 D kcal/oz) [13]

5 Similac PM 60/40 (Ross Laboratories) Good Start (Carnation Nutritional Products) PM 60/40 Good Start 100% [14] ( ) ( meq/dl ) ( mg/day) D 240 ml/day ( ) LDL VLDL B (apolipoprotein B) HDL day ) (lipoprotein lipase) (lecithin-cholesterol acetyltransferase) (hepatic triglyceride lipase) ( 5 g/kg/ 6.5 meq/dl

6 [17] 1995 Warady BA 27 ( ) 2 (7%) 90% (ideal body weight, ie wt/wh at 50th percentile) [18] [15] (North American Pediatric Renal Transplant Cooperative Study) [19] (creatinine clearance) (ultrafiltration) [20] 4 12 Coleman 22 [16] [5]

7 1. Richard N. Fine, Steven R. Alexander, Bradley A. Warady: Nutritional Therapy for Children on CAPD/CCPD: Theory and Practice, CAPD/ CCPD in Children 2nd Edition, Kluwer Academic Publishers, USA 1998; Canepa A, Perfumo F, Carrea A, et al: Nutritional status in children receiving chronic peritoneal dialysis. Perit Dial Int 1996; 16(Suppl 1): S Churchill DN, Taylor DW, Keshaviah PR: Adequacy of dialysis and nutrition in continuous peritoneal dialysis: association with clinical outcome. Canada-USA Peritoneal Dialysis Study Group. J Am Soc Nephrol 1996; 7: Watson AR, Coleman JE, Taylor EA: Gastrostomy Buttons for Feeding Children on Continuous Cycling Peritoneal Dialysis. In: Khanna R et al (eds). Advances in Peritoneal Dialysis 1992; Izhar UQ, Donna S, Leo L, et al: Effects of amino acid dialysis to dextrose dialysis in children on continuous cycling peritoneal dialysis. Perit Dia Int 1999; 19: Young GA, Kopple JK, Lnndholm B, et al: Nutritional assessment of continuous ambulatory peritoneal dialysis patients: an international study. Am J Kidney Dis 1991; 17(4): Ruley EJ,Bock GH, Kerzner B, et al: Feeding disorders and gastroesophageal reflux in infants with chronic renal failure. Pediatr Nephrol 1989; 3: Heimburger O, Bergstrom J, Lindholm B: Maintenance of optimal nutrition in CAPD. Kidney Int 1994; 46 (Suppl 48): S Nelson P, Stover J: Nutrition recommendations for infants, children, and adolescents with end-stage renal disease, A clinical guide to nutrition care in end-stage renal disease. Chicago Ill: American Diet Association, 1994; FAO/WHO/UNU Expert Consultation. Energy and protein requirements. WHO. Geneva p Makoff R, Dwyer J, Rocco MV: Folic acid, pyridoxine, cobalamin, and homocysteine and their relationship to cardiovascular disease in end-stage renal disease. J Renal Nutr 1996; 6(1): Hellerstein S, Hollidaay MA, Grupe WE, et al: Nutritional management of children with chronic renal failure. Summary of the task force on nutritional management of children with chronic renal failure. Pediatr Nephrol 1987; 1: Yiu VWY, Harmon WE, Spinozzi N, et al: High-calori nutrition for infants with chronic renal disease. J Renal Nutr 1996; 6(4): Fried MD, Khoshoo V, Sgcker Dj, et al: Decrease in gastric emptying tome and episodes of regurgitation in children with spastic quadriplegia fed a whey-based formula. J Pediatr 1992; 120: Richard N. Fine, Steven R. Alexander, Bradley A. Warady BA: When and how to use nasogastric and gastrostomy feeding for nutritional support in infants and children on CAPD/CCPD, CAPD/CCPD in children 2nd Edition, Kluwer Academic Publishers, USA 1998; Coleman JE, Watson AR, Rance CH, et al: Gastrostomy buttons for nutritional support on chronic dialysis. Nephrol Dial Transplant 1998; 13: Gauderer MWL, Picha GJ, Izant RJ Jr: The gastrostomy "button"- A simple, skin-level, nonrefluxing device for longterm enteral feedings. J Pedistr Surg 1984; 19: Warady BA: Neuro-developmental issues in infants on peritoneal dialysis. Presented at the sixth Annual Pediatric PD symposium, Baltimore, Maryland, Feb Eileen NE, Verna Yiu, Frances H et al: The impact of supplemental feeding in young children on dialysis: A report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Nephrol 2001; 16: Alberto C, Enrico V, Francesco P, et al: Value of international amino acids in children treated with chronic peritoneal dialysis. Perit Dia Int 1999; 19 (supp2): S