Dietary protein restriction benefits patients with chronic kidney disease

被引:49
作者
Mandayam, S
Mitch, WE
机构
[1] Baylor Coll Med, Div Nephrol, Houston, TX 77030 USA
[2] Univ Texas, Med Branch, Div Nephrol, Galveston, TX 77550 USA
关键词
chronic kidney failure; low-protein diet; progression; protein intolerance; uraemic toxins;
D O I
10.1111/j.1440-1797.2006.00528.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The prevalence of chronic kidney disease (CKD) is rapidly increasing so every strategy should be used to avoid the complications of CKD. Most CKD symptoms or uraemia are caused by protein intolerance; symptoms arise because the patient is unable to excrete metabolic products of dietary protein and the ions contained in protein-rich foods. Consequently, CKD patients accumulate salt, phosphates, uric acid and many nitrogen-containing metabolic products, and secondary problems of metabolic acidosis, bone disease and insulin resistance become prominent. These problems can be avoided with dietary planning. Protein-restricted diets do not produce malnutrition and with these diets even patients with advanced CKD maintain body weight, serum albumin and normal electrolyte values. Non-compliance is a problem, but this can be detected using standard techniques to provide the patient with appropriate responses. The role of dietary protein restriction in the progression of CKD has not been proven, but it can reduce albuminuria and will prevent uraemic symptoms. Until a means of preventing kidney disease or progression is found, safe methods of management such as dietary manipulation should be available for CKD patients.
引用
收藏
页码:53 / 57
页数:5
相关论文
共 67 条
[1]   Diabetic nephropathy: Linking histology, cell biology, and genetics [J].
Adler, S .
KIDNEY INTERNATIONAL, 2004, 66 (05) :2095-2106
[2]  
[Anonymous], 1985, WHO TECH REP SER, P1
[3]  
[Anonymous], 1869, KIDNEY DIS URINARY D
[4]   EFFECT OF A LOW-PROTEIN DIET ON URINARY ALBUMIN EXCRETION IN UREMIC PATIENTS [J].
APARICIO, M ;
BOUCHET, JL ;
GIN, H ;
POTAUX, L ;
MOREL, D ;
DEPRECIGOUT, V ;
LIFERMANN, F ;
GONZALEZ, R .
NEPHRON, 1988, 50 (04) :288-291
[5]  
Aparicio M, 2001, J NEPHROL, V14, P433
[6]  
Aparicio M, 2000, J AM SOC NEPHROL, V11, P708, DOI 10.1681/ASN.V114708
[7]  
APARICIO M, 1987, METABOLISM, V36, P1080
[8]   Resting energy expenditure of chronic kidney disease patients: Influence of renal function and subclinical inflammation [J].
Avesani, CM ;
Draibe, SA ;
Kamimura, MA ;
Colugnati, FAB ;
Cuppari, L .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2004, 44 (06) :1008-1016
[9]   The acidosis of chronic renal failure activates muscle proteolysis in rats by augmenting transcription of genes encoding proteins of the ATP-dependent ubiquitin-proteasome pathway [J].
Bailey, JL ;
Wang, XN ;
England, BK ;
Price, SR ;
Ding, XY ;
Mitch, WE .
JOURNAL OF CLINICAL INVESTIGATION, 1996, 97 (06) :1447-1453
[10]   Impact of timing of initiation of dialysis on mortality [J].
Beddhu, S ;
Samore, MH ;
Roberts, MS ;
Stoddard, GJ ;
Ramkumar, N ;
Pappas, LM ;
Cheung, AK .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (09) :2305-2312