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엄영람 대한신장학회 1985 Kidney Research and Clinical Practice Vol.4 No.1
The dietary management of the patients on CAPD is important for the maintenance of the optimal nutritional state. The nutritional requirements for the patients on CAPD may be greater than the normal because proteins, amino acids and other water-soluble nutrients are lost into the dialysate. The intake of 1.2 to 1 .3 gm of high biological value protein per kilogram of ideal body weight per day is recommended. Higher amounts are prescribed in case of protein malnutrition or peritonitis. The energy intake of 35 to 42 kcal per kilogram of ideal body weight per day is recommended, but there is a substantial energy intake from the glucose absorbed from dialp sate. So dietary caloric intake should be modified, taking into account calories absorbed from dialysate. The hypertriglyceridemia often seen in the patients on CAPD is reduced when the dietary intake of carbohydrate is reduced to 50Yo of total calories or less and the intake of polyunaaturated fats is increased. Sodium, potassium and fluid intake are moderately restricted according to water balance, .serum sodium and serum potassium. Daily recommended dietery phosphorus intake is 800 to 1,200 mg, High phosphorus foods such as whole grains, nuts and legumes should be lirnited(one serving per week). Deficiency of certain water-solube vitamins can result from CAPD. Daily supplements of water-soluble vitamins and the recommended allowances for the other vitamins should be prescribed.
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엄영람 대한신장학회 1988 Kidney Research and Clinical Practice Vol.7 No.3
The dietary management in hemodialysis patients is important to prevent deficiency and achieve good nutritional status, because the nutritional status may play a key role in the survival of hemodialysis patients. The intake of 1 to 1.2 gm of high biological value protein per kilogram of ideal body weight is recommended per day. However protein requirements in hemodialysis patients are influenced by several factors (Amino acids loss into the dialysate, Blood loss, Uremic catabolism, Proteinuria and so on.) Energy intake must be adequate in order to spare protein for tissue protein synthesis and prevent its metabolism for energy. Depending on the patients present nutritional status and degree of stress, between 35 and 50 kcal per kilogram of ideal body weight should be provided. The sodium and fluid intake are modified through measurement of urinary sodium excretion, urine output, blood pressure, presence of edema, serum sodium level and dietary intake. Usually the sodium intake of 40 to 120 mEq per day and the fluid intake of 500 ml per day plus the amount equal to urinary output are allowed. Potassium usually requires restriction, depending upon the individual's body size, the 24-hour urinary potassium excretion, the serum potassium level and the frequency of dialysis. Potassium is recommended 40 to 65 mEq (1.5 to 2.5 gm) per day. The daily recommended dietary phosphorus and calcium intake is 1200 mg or less, 1.5 to 2.5 gm, respectively, but calcium is increased by giving calcium supplements. There are several causes of vitamin deficiency in hemodialysis patients. So daily supplements of water-soluble vitamins and the recommended allowances for the other vitamins should be prescribed. Finally, the nutrient intake must always be adjusted according to the clinical response of the individual patient, even though dietary allowance for other nutrients are proposed.
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엄영람,류은순 대한영양사협회 2003 대한영양사협회 학술지 Vol.9 No.3
The study was conducted to identify dietitians' position and role by assessing the present condition on management of human resources in contract-managed foodservice companies. Questionnaires were distributed to 79 contracted companies(eight large-size, 48 mid-size, 23 small-size companies) from March to May in 2002. About eighty-five percent of contracted foodservice companies employed the new dietitians as full time employees, and seventy-five percent of them were promoted the dietitians by evaluation after a given period of time. As a starting payment for university graduates, large-size companies payed an average of 16,260,000 won/year, which was significantly higher(p<0.01) than those of mid-sized(11,320,000 won/year) and small-sized companies(11,620,000 won/year). The mean lengths of dietitians' service were 33.5 months in large-size companies, 26.5 months in mid-sized companies, 26.0 months in small-sized companies. It was less than 3 years in all companies(avg. 26.9 months). Fifty-four companies(68.4%) employed dietitians in each foodservice contract, whereas 25 companies didn't employ dietitians. The ratios of dietitians out of employees in each department of the companies were 42.6% in the department of contracted foodservice management, 19.9% in the department of menu development, 18.1% in the department of food safety, 8.7% in the department of distribution and purchase, 4.2% in the department of business, and 3.9% in the department of customer satisfaction. The dietitians' positions were directors in two companies(2.5%), general managers in two companies(2.5%), deputy managers in seven companies(8.9%), managers in twenty-nine companies(36.7%), assistant managers/chief clerks in twenty-four companies(30.4%), and chiefs in twenty-five companies(31.6%). The frequencies of training for dietitians were 6.2 times/year for the food safety training, 5.8 times/year for the cooking training, 4.8 times/year for nutrition-related training, and 4.7 times/year for service training.
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