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Akut Böbrek Hasarında Beslenme Desteği

Nutritional Support in Acute Kidney Injury

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
DOI 10.5262/tndt.2013.1001.02

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Acute kidney injury (AKI) is a frequent complication affecting many hospitalized patients and is associated with increased morbidity and mortality. AKI seldom occurs as isolated organ failure; much more often it emerges as a component of the multiple organ failure syndrome, within the framework of the severe-prolonged catabolic phase determined by critical illness. Patients with AKI often have protein-energy wasting, which represents a major negative prognostic factor. Malnutrition in AKI patients is associated with increased risk of complications, longer hospitalization, and higher hospital mortality. Hence, appropriate nutritional support is essential in the management of the AKI patient. Assessment of nutritional requirements should take into account the patient’s underlying disease, comorbid medical conditions, severity of the renal dysfunction and need for RRT. The primary goals of nutritional support in AKI are the same as those suggested for critically ill patients with normal renal function: to ensure the delivery of adequate amounts of nutrients, to prevent protein-energy wasting with the attendant metabolic complications, to reduce mortality. Since AKI comprises a highly heterogeneous group of subjects with nutrient needs widely varying even along the clinical course in the same patient, nutritional requirements should be frequently reassessed, individualized and carefully integrated with RRT..
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Abstract (Original Language): 
Akut böbrek hasarı (ABH), hastanede yatan hastalarda oldukça sık karşılaşılan bir komplikasyondur ve morbidite ve mortalitede artış ile ilişkilidir. ABH nadiren izole organ yetmezliği olarak görülür, daha sıklıkla kritik hastalık olarak tanımlanan ciddi ve uzamış katabolik faz ile karakterize çoklu organ yetmezliği sendromunun bir parçası olarak ortaya çıkar. ABH’lı hastalar sıklıkla protein-enerji tüketimi içindedir ki bu önemli bir olumsuz prognostik faktördür. Akut böbrek hasarlı hastalarda malnütrisyon, komplikasyon gelişme riski, hospitalizasyon süresi ve hastane mortalitesinde artış ile ilişkilidir. Bu nedenle ABH’lı hastaların tedavisinde uygun beslenme desteğinin yer alması elzemdir. Beslenme gereksinimi değerlendirilirken hastanın altta yatan hastalığı, komorbid durumları ve böbrek fonksiyon bozukluğunun ciddiyeti ile renal replasman tedavisi (RRT) ihtiyacı dikkate alınmalıdır. ABH’da beslenme desteğinin esas amacı, normal böbrek fonksiyonuna sahip kritik hastalar için önerilene benzerdir: yeterli miktarda besin öğesi sağlandığından emin olmak, metabolik komplikasyonlara eşlik eden protein-enerji tüketimini önlemek ve mortaliteyi azaltmak. ABH, aynı hastanın bile klinik takip süresince büyük ölçüde değişen beslenme ihtiyacına sahip olduğu oldukça heterojen bir hasta grubunu kapsadığından beslenme gereksinimi açısından değerlendirme aralıklı olarak tekrar edilmeli, bireyselleştirilmeli ve RRT ile bütünleştirilmelidir.
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