营养与饮食学会对KDOQI CKD营养临床实践指南中磷推荐的评论:2020年更新。

IF 3.4 3区 医学 Q2 NUTRITION & DIETETICS
Joyce Marcley Vergili EdD, RD, CSR, CDN, CDCES, FAND , Gabriela V. Proaño MS, RDN , Elizabeth Yakes Jimenez PhD, RDN , Lisa Moloney PhD, RDN , Constantina Papoutsakis PhD, RD , Alison Steiber PhD, RDN
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引用次数: 0

摘要

肾脏疾病结局质量倡议(KDOQI)慢性肾脏疾病(CKD)营养临床实践指南:2020年更新建议调整膳食磷,以维持血液透析患者在正常范围内(0.81至1.45 mmol/L[2.5至4.5 mg/dL])的血清磷酸盐目标。这低于许多透析中心使用的血清磷酸盐目标(0.97至1.78 mmol/L[3.0和5.5 mg/dL])。尽管在为患者提供个性化护理时必须始终考虑环境和临床判断,但2020年12月至2022年12月进行的一项指南实施研究发现,根据他们的文件,来自两个国家透析链的注册营养师营养学家几乎普遍使用透析中心目标,而不是指南推荐的较低的磷酸盐目标。本评论讨论了实施KDOQI 2020营养指南中磷建议的可能障碍,并提出了一种系统级方法来促进和支持该建议的采用。呼吁对临床医生实践、组织/机构文化和政府法规的潜在变化采取行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Academy of Nutrition and Dietetics Commentary on the Phosphorus Recommendation in the KDOQI Clinical Practice Guidelines for Nutrition in CKD: 2020 Update

The Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in Chronic Kidney Disease: 2020 Update recommends adjusting dietary phosphorus to maintain a serum phosphate goal for hemodialysis patients in the normal range (0.81 to 1.45 mmol/L [2.5 to 4.5 mg/dL]). This is lower than the serum phosphate goal used by many dialysis centers (0.97 to 1.78 mmol/L [3.0 and 5.5 mg/dL]). Although context and clinical judgment must always be considered when providing individualized care to patients, a guideline implementation study conducted from December 2020 to December 2022 found that, based on their documentation, registered dietitian nutritionists from two national dialysis chains are almost universally using dialysis center goals instead of the lower phosphate goal recommended by the guideline. This commentary discusses the possible barriers to implementing the Kidney Disease Outcomes Quality Initiative 2020 nutrition guideline's phosphorus recommendation and proposes a systems level approach to promote and support adoption of the recommendation. Calls to action for potential changes in clinician practices, organizational/institutional culture, and government regulations are put forth.

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来源期刊
Journal of Renal Nutrition
Journal of Renal Nutrition 医学-泌尿学与肾脏学
CiteScore
5.70
自引率
12.50%
发文量
146
审稿时长
6.7 weeks
期刊介绍: The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.
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