Malnutrition and Nutrition in Dialysis Patients/Diyaliz Hastalarında Malnütrisyon ve Beslenme

Öz

Malnutrition is a common and serious complication among dialysis patients, leading to increased morbidity and mortality. Insufficient nutrient intake results in reduced body weight and energy stores, loss of muscle mass, and decreased visceral protein levels. This condition increases the risk of infections, suppresses immune function, and delays wound healing. The main causes of malnutrition include poor appetite, restrictive diets, medication side effects, metabolic acidosis, inflammation, alterations in the gut microbiota, and nutrient losses that occur during dialysis. Compared to healthy individuals, dialysis patients have higher protein requirements, and an intake of 1.2 g/kg/day is recommended. Energy needs vary depending on physical activity level but generally range from 35-40 kcal/kg/day. Assessment of malnutrition involves biochemical parameters, dietary protein intake, anthropometric measurements, and body composition analysis. Serum albumin is the most commonly used marker, and low levels are associated with higher mortality. Malnutrition not only increases mortality risk but also negatively affects quality of life. Nutritional management should focus on individualized dietary plans and psychosocial support to prevent and treat this condition. The aim of this review is to comprehensively evaluate the prevalence, causes, and consequences of malnutrition in dialysis patients based on current literature.

Anahtar Kelimeler

• Albumin
• Dialysis
• Malnutrition
• Undernutrition

Diyaliz Hastalarında Malnütrisyon ve Beslenme/Malnutrition and Nutrition in Dialysis Patients

Öz

Malnütrisyon, diyaliz hastalarında sık görülen ve yüksek morbidite ile mortaliteye neden olan önemli bir komplikasyondur. Yetersiz besin alımı, vücut ağırlığı ve enerji depolarında azalmaya, kas kütlesinde kayba ve visseral protein seviyelerinde düşüşe yol açar. Bu durum enfeksiyon riskini artırır, bağışıklığı baskılar ve yara iyileşmesini geciktirir. Malnütrisyonun başlıca nedenleri arasında iştahsızlık, kısıtlayıcı diyetler, ilaç yan etkileri, metabolik asidoz, inflamasyon, bağırsak mikrobiyotasındaki değişiklikler ve diyaliz sırasında yaşanan besin kayıpları yer alır. Diyaliz hastalarında protein ihtiyacı sağlıklı bireylere göre daha yüksektir ve günde kilogram başına 1,2 g protein alımı önerilmektedir. Enerji ihtiyacı ise yaş ve fiziksel aktivite düzeyine bağlı olarak günde 30-35 kcal/kg’dır. Malnütrisyonun değerlendirilmesinde biyokimyasal parametreler, diyet protein alımı, antropometrik ölçümler ve vücut kompozisyon analizleri kullanılmaktadır. Serum albümin seviyesi en yaygın kullanılan parametre olup düşük seviyeler yüksek ölüm oranı ile ilişkilidir. Malnütrisyon, mortalite riskini artırırken yaşam kalitesini olumsuz etkiler. Beslenme yönetimi, bireyselleştirilmiş diyet planları ve psikososyal destek ile bu durumun önlenmesi ve tedavisi hedeflenmelidir. Bu derlemenin amacı, diyaliz hastalarında malnütrisyonun görülme sıklığını, nedenlerini ve sonuçlarını mevcut literatür doğrultusunda kapsamlı şekilde değerlendirmektir.

Anahtar Kelimeler

• Albümin
• Diyaliz
• Malnütrisyon
• Yetersiz Beslenme

Kaynakça

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