[Purpose] We evaluated the effect of physiotherapy on physical function, exercise tolerance, and the phase angle (PA) of a maintenance hemodialysis patient. [Participant and Methods] The subject was a 75-year-old male patient with end-stage renal failure due to diabetic nephropathy who was being treated with hemodialysis. Physiotherapy was performed three times a week for 12 weeks before dialysis, and consisted of six types of resistance training which were performed for about 20 minutes per session. [Results] Improvement in physical function was observed, and the severity of hypo-nutrition and sarcopenia improved, with PA improving from 4.0° to 4.3°. [Conclusion] The results suggest that 12 weeks of resistance training improves the PA of maintenance hemodialysis patients. 

Improvement Effect of Resistance Training on the Phase Angle of Maintenance Hemodialysis Patients: A Case Report

透析患者の栄養評価法に関する最近の話題は，Nutritional Risk Index for Japanese Hemodialysis patients（NRI–JH）とGLIM（the Global Leadership Initiative on Malnutrition）基準である．NRI–JH は日本人血液透析患者向けの新たな栄養指標であり，短期的な生命予後の予測に優れる．一方，GLIM 基準の予後予測能は，透析患者では感度，特異度とも低いため，従来の栄養評価法が優先される．Asian Working Group for Sarcopenia（AWGS）2019 によると，透析患者の27～68％にサルコペニアを合併している．診断項目にある握力および5 回椅子立ち上がりテストのカットオフ値は，予後予測に有用である．透析患者の栄養障害には，経腸栄養剤（oral nutritional supplements：ONS）による経腸栄養が第一選択であり，3 か月以上の継続が勧められる．透析時静脈栄養（intradialytic parenteral nutrition：IDPN）は，少なくともエネルギー≥20 kcal/kg/日，たんぱく質≥0.8 g/kg/日を摂取している透析患者が対象となる．現在，透析患者でも一般用のアミノ酸製剤やキット輸液製剤が使えるため，ONS とIDPN で必要量を確保できない場合には中心静脈栄養を検討する． 

透析患者のProtein–energy wasting，サルコペニア， フレイルに関する最近の話題

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透析患者のProtein–energy wasting，サルコペニア，フレイルに関する最近の話題

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透析患者のProtein–energy wasting，サルコペニア， フレイルに関する最近の話題

透析患者のProtein–energy wasting，サルコペニア，フレイルに関する最近の話題