常见的高磷血症健康教育.ppt

磷的代谢途径 * Key point: Dietary restriction of phosphate, dialysis, and binder medication are the mainstays of managing phosphorus burden in patients who have ESRD. Management of phosphorus burden in patients who have ESRD is typically achieved through Diet – reducing dietary intake phosphate with a low-phosphate diet Dialysis – removing serum phosphorus from the blood by dialysis Medication – reducing the absorption of dietary phosphate with phosphate binder medication Today, challenges related to the renal diet that is typically prescribed to ESRD patients will be presented, as well as information about the noncalcium phosphate binder FOSRENOL as a medication option Reference Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guidelines for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease–mineral and bone disorder (CKD-MBD). Kidney Int. 2009;76(suppl 3):S1-S130. *  骨痛 心血管 病变 肢端 溃烂 抽搐 骨 折 皮肤瘙痒 红眼 高磷血症的健康教育 血液净化科 范琳 70% 30% 正常血磷值 2.5-4.5mg/dl (0.8-1.45mmol/L) 后期改变 小动脉钙化 小血管钙化 KDIGO CKD-MBD Work Group. Kidney Int. 2009;76(suppl 3):S1-S130. Not for Promotional Use - Not for Distribution 高磷血症的控制策略 透析 药物 使用磷结合剂减少食物中磷的吸收 减少饮食磷的摄入 通过透析降低血磷 食物 手术 健康教育 饮食限磷 采取低磷饮食，限制磷的摄入在800-1000mg/d. 正常食物摄 入1-1.2g/kg/d 蛋白 限制蛋白 低磷高蛋白 饮食 高磷 营养不良 费用昂贵 到底该吃什么好呢？ 常见的高磷食物 常见的低磷食物 每天食物大概包括 食物种类 用 量 鸡蛋 一个 牛奶 一袋 蔬菜、水果 一斤 瘦肉 2两 主食 6-8两 盐 5g 油 25g * Key point: Dietary restriction of phosphate, dialysis, and binder medication are the mainstays of managing phosphorus burden in patients who have ESRD. Management of phosphorus burden in patients who have ESRD is typically achieved through Diet – reducing dietary intake phosphate with a low-phosphate diet Dialysis – removing serum phosphorus from the blood by dialysis Medication – reduci