Let’s Take A Look At Hemodialysis Anorexia Intervention Strategies
Mar 04, 2024
Hemodialysis is the most important treatment for uremia, but due to strict dietary restrictions and dialysis-related intestinal reactions, 30% to 70% of dialysis patients will develop anorexia symptoms. Anorexia patients can easily lead to muscle atrophy and weight loss due to nutritional deficiencies, which can lead to decreased immunity and threaten the patient's life.
Improve hemodialysis methods
Inadequate hemodialysis is the most important reason for anorexia in dialysis patients.
Click to Cistanche for kidney disease
Research shows that increasing the frequency of dialysis and increasing the dose of dialysis can effectively improve patients' anorexia. Increasing the frequency of daytime hemodialysis or nighttime hemodialysis in a short period can also improve patients' appetite and food intake.
Benefits of improved dialysis methods:
1) Can reduce fluctuations in liquids, solutes, and electrolytes;
2) Improve patients' fatigue after dialysis;
3) Reduce liquid overload;
4) Improve the uremia environment;
5) Remove large and medium-sized molecules from the body.
Increasing daily dialysate volume during peritoneal dialysis can significantly reduce the frequency of anorexia in patients.
Therefore, when a patient is suspected of having anorexia and declining nutritional status, the dialysis dose should be appropriately adjusted according to the dialysis status, so that the adequacy of dialysis can be maintained within a reasonable range to ensure the patient's good appetite.
Dialysis nutritional support
Active nutritional support for hemodialysis patients can reduce the risk of death in dialysis anorexia patients, and artificial nutritional support (oral or intravenous injection) can improve malnutrition caused by anorexia.
1) Oral nutritional support (ONS) can improve patients' appetite and nutritional status
Oral administration of an average of 1548.77kJ nutritional solution per day can improve the expression of nutritional biomarkers and the survival rate of hemodialysis patients. Providing ONS to hemodialysis patients with serum albumin <35g/L and maintaining ONS until the patient's serum albumin level reaches 40g/L can reduce patient mortality by 9%.
2) Protein-Energy Expenditure (PEW)
Although PEW may not be a direct cause of death on dialysis, PEW may aggravate a patient's preexisting heart failure and increase susceptibility to infection, resulting in poor prognosis. Therefore, medical staff and patients should also actively target PEW to improve their nutritional status.
Improve appetite in dialysis patients
Clinical studies have shown that the use of some drugs can help improve the appetite of dialysis patients.
1) Progesterone acetate
Appetite stimulation for dialysis patients. Progesterone acetate is a semi-synthetic progesterone. It was originally used to treat metastatic breast cancer and endometrial cancer. It can increase the patient's appetite and weight, so it gradually becomes the acquired immunodeficiency syndrome. or established treatment of malnutrition in patients with nonhormone-responsive cancer. Progesterone acetate can also play a good role in anorexic patients on dialysis. Therefore, progesterone acetate can be used to treat anorexia in maintenance hemodialysis patients in the future.
2) Ghrelin
Subcutaneous injection of ghrelin increases food intake in malnourished patients with Parkinson's disease. Ghrelin and its analogs may also help treat anorexia in dialysis patients, but their specific effects require further verification.
Dialysis dietary guidance
Many dialysis patients do not understand their nutritional needs, especially during hospitalization. Factors such as examinations, surgeries, psychology, and the disease itself can lead to insufficient food intake. Therefore, the European best practice guideline DOQI recommends that hemodialysis patient undergoes dietary counseling. Intensive nutritional counseling is usually the first step in managing patients with anorexia.
Nutritional counseling has a positive impact on dialysis patients with reduced appetite. Through consultation and the provision of tailor-made nutritional support programs, the morbidity and mortality of dialysis patients with anorexia can be reduced to that of non-anorexia patients.
Control inflammation
Anorexia is associated with higher serum cytokine levels. Reducing nosocomial infections and controlling inflammation with drugs are feasible treatments that can help alleviate patients' anorexia.
In clinical work, medical staff must strictly perform aseptic operations, perform regular disinfection and inspections on patients with long-term catheterization, and provide timely drug treatment to patients with inflammation.
Anorexia is relatively common among dialysis patients and has complex causes. It not only has a great impact on patients' nutritional status and quality of life but also increases the mortality of dialysis patients. Domestic research on anorexia is still in its infancy. The treatment of anorexia in dialysis patients is mainly clinical controlled trials of traditional Chinese medicine. There is no unified opinion on the understanding and evaluation of anorexia.
At present, there are many available assessment tools for anorexia in dialysis patients internationally and a clearer understanding of the pathogenesis and intervention methods of anorexia in dialysis patients has been formed. This has important implications for the clinical research on anorexia in dialysis patients in China. It has reference significance.
In the future, it is necessary to form a unified understanding of anorexia in dialysis patients based on my country's conditions, conduct in-depth research on different pathogenesis, and provide theoretical support for the development of relevant intervention strategies.
How Does Cistanche Treat Kidney Disease?
Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.
Kidney disease, also known as renal disease, is a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.
Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.
Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.
Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.
Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.
Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.
In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.
In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.
