Mandayam Sreedhar, Mitch William E
Nephrology Division, University of Texas Medical Branch, Galveston, USA.
Nephrology (Carlton). 2006 Feb;11(1):53-7. doi: 10.1111/j.1440-1797.2006.00528.x.
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.
慢性肾脏病（CKD）的患病率正在迅速上升，因此应采用各种策略来避免CKD的并发症。大多数CKD症状或尿毒症是由蛋白质不耐受引起的；症状出现是因为患者无法排泄膳食蛋白质的代谢产物以及富含蛋白质食物中所含的离子。因此，CKD患者会积累盐、磷酸盐、尿酸和许多含氮代谢产物，代谢性酸中毒、骨病和胰岛素抵抗等继发性问题变得突出。通过饮食规划可以避免这些问题。蛋白质限制饮食不会导致营养不良，采用这些饮食，即使是晚期CKD患者也能维持体重、血清白蛋白和正常电解质值。不依从是一个问题，但可以使用标准技术检测到，以便为患者提供适当的应对措施。饮食蛋白质限制在CKD进展中的作用尚未得到证实，但它可以减少蛋白尿并预防尿毒症症状。在找到预防肾脏疾病或疾病进展的方法之前，应为CKD患者提供安全的管理方法，如饮食控制。
