Management of hypoalbuminemia: A challenge for the health care team
| Autor: | Carolyn Cochran, Charles J. Foulks, Alice Chan, Joanne Bright, Evey Luce Muniz, James Lindley, Glenda Harbert |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Nutrition and Dietetics Quality management business.industry medicine.medical_treatment Medicine (miscellaneous) medicine.disease Parenteral nutrition Nursing Nephrology Multidisciplinary approach Intervention (counseling) Health care medicine Hypoalbuminemia Hemodialysis Intensive care medicine business Team management |
| Zdroj: | Journal of Renal Nutrition. 6:38-44 |
| ISSN: | 1051-2276 |
| DOI: | 10.1016/s1051-2276(96)90107-7 |
| Popis: | Hypoalbuminemia has been linked to an increased risk of mortality and morbidity in dialysis patients. The 1994 Health Care Financing Administration's Core Indicator Project reported that one in five adult hemodialysis patients had inadequate nutritional status as reflected by low serum albumin (SA) concentrations. In response to the need for education, intervention, and quality improvement tools, the ESRD Network No. 14 Medical Review Board formed a multidisciplinary task force to develop an algorithm for the team management of hypoalbuminemia. The Nutrition Subcommittee, representing renal dietitians from various practice settings across the state and dietitians from two metropolitan Council on Renal Nutrition chapters, was enlisted to provide professional validation. A systematic approach for overcoming barriers to adequate nutrient intake, which may improve low SA concentrations is outlined. The first step requires assurance of adequate dialysis. The second step focuses on assessment of nutrient intake, counseling, and education of the patient and significant others. The third step involves the coordinated efforts of the health care team in identifying, evaluating, and treating all concomitant conditions affecting the patient's nutritional status. More aggressive therapies, such as tube feeding, should be considered for willing candidates who cannot consume adequate protein and calories. The use of parenteral nutrition is reserved for patients with gastrointestinal dysfunction who do not respond to therapy administered via gastrointestinal routes. Each health care team member brings the strength of his or her unique perspective to the assessment and development of strategies. The multidisciplinary management approach, in partnership with the patient, enhances cooperation and problem solving to achieve desired outcomes. |
| Databáze: | OpenAIRE |
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