Teplan V, Schück O, Stollová M
Klinika nefrologie, Transplantacní centrum IKEM a Subkatedra nefrologie IPVZ, Praha.
Vnitr Lek. 2004 Jul;50(7):550-5.
Conservative treatment implies procedures which involve normalization or improvement of metabolic disorders in chronic renal insufficiency and failure by medicamentous and dietary means. Keto amino acids administration can remarkable influence protein synthesis, metabolic acidosis, Ca-P and PTH levels, carbohydrate and lipid disorders, but has no effect on hyperfiltration. Long-term co-administration of rHuEPO and keto amino acids in CRF patients on LPD has accelerated metabolic effect associated with a delay in progression of renal failure and reduction of proteinuria. Also, concomitant administration of ACE inhibitors and angiotensin II AT1 receptor antagonist in CRF patients on LPD with KA was associated with significant decrease of proteinuria, amino-aciduria and, via its glomerulo-tubular action, it had also an effect on progression of CRF.
保守治疗是指通过药物和饮食手段使慢性肾功能不全和肾衰竭患者的代谢紊乱恢复正常或得到改善的治疗方法。给予酮氨基酸可显著影响蛋白质合成、代谢性酸中毒、钙磷和甲状旁腺激素水平、碳水化合物和脂质紊乱，但对超滤无影响。在接受低蛋白饮食的慢性肾衰竭患者中长期联合使用重组人促红细胞生成素和酮氨基酸，可加速代谢效应，延缓肾衰竭进展并减少蛋白尿。此外，在接受低蛋白饮食并服用酮氨基酸的慢性肾衰竭患者中，同时给予血管紧张素转换酶抑制剂和血管紧张素II AT1受体拮抗剂，可使蛋白尿、氨基酸尿显著减少，并且通过其肾小球-肾小管作用，对慢性肾衰竭的进展也有影响。
