营养干预是肾脏疾病管理的重要组成部分。这项研究旨在了解目前全球肾脏营养护理服务的可用性和能力,跨学科交流,以及口服营养补充剂的可用性。
国际肾脏营养与代谢学会(ISRNM),与国际肾病学会(ISN)全球肾脏健康地图集委员会合作,开发了这个全球肾脏营养保健地图集。2018年7月至9月,通过182个ISN附属国家对主要肾脏护理利益相关者进行了电子调查。
总的来说,182个国家中有160个(88%)做出了回应,其中155个国家(97%)回答了与肾脏营养护理相关的调查项目。在155个国家中,只有48%的国家有营养师/肾脏营养师提供这种专门服务。饮食咨询,由受过营养训练的人提供,在65%的低收入/中低收入国家普遍没有,在23%的低收入国家“从来没有”可用。41%的国家没有为肾脏营养护理提供正式的营养状况评估。口服营养补充剂的供应在全球范围内各不相同,大多数情况下,在低收入/中低收入国家,住院和门诊均无法免费获得。营养师和肾病学家仅在全球≥60%的国家/地区就肾脏营养护理“有时”进行了交流。
这项调查揭示了全球肾脏营养护理服务能力的巨大差距,可用性,成本覆盖,以及肾脏营养护理提供的跨学科交流不足,特别是在低收入国家。
Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements.
The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018.
Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle-income countries and \"never\" available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle-income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated \"sometimes\" on kidney nutrition care in ≥60% of countries globally.
This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.