Wingen A M, Fabian-Bach C, Mehls O
Division of Paediatric Nephrology, University Children's Hospital, Heidelberg, Federal Republic of Germany.
Pediatr Nephrol. 1991 Jul;5(4):496-500. doi: 10.1007/BF01453689.
In 1988 the European Study for Nutritional Treatment of Children with Chronic Renal Failure started its multicentre randomized trial to investigate the influence of protein intake on the progression of renal failure. A total of 284 children had been registered. Of these 221 were accepted for the study. The data from 105 patients after 1 year of study are available for preliminary analysis. Fifty children were randomized for the diet group and 55 for the control group. Both groups were comparable concerning age, glomuerlar filtration rate (GFR) and height standard deviation score for chronological age at the start of the study period and the distribution of primary renal diseases and sex. Limits for protein and energy intake were set according to the safe levels and recommendations given by the World Health Organization. The compliance with dietary prescriptions as calculated from dietary diaries was good. A low-protein diet did not do any harm to the children with respect to length gain and weight gain. The progression of renal failure was minimal in the diet group (mean loss of GFR 3.6 ml/min per 1.73 m2 per year) as well as in the control group (2.3 ml/min per 1.73 m2 per year). The differences between the diet group and the control group were statistically not significant when either all patients or only subgroups of various primary renal diseases were analysed. When only patients with a good compliance were considered (documented by dietary diaries or by urea nitrogen excretion) the same results were obtained. In summary, reduction of protein intake was accepted by the majority of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
1988年,欧洲儿童慢性肾衰竭营养治疗研究启动了其多中心随机试验,以调查蛋白质摄入量对肾衰竭进展的影响。共有284名儿童登记在册。其中221名被纳入研究。研究1年后,105名患者的数据可用于初步分析。50名儿童被随机分配到饮食组,55名儿童被随机分配到对照组。在研究期开始时,两组在年龄、肾小球滤过率(GFR)以及按实足年龄计算的身高标准差得分、原发性肾脏疾病分布和性别方面具有可比性。蛋白质和能量摄入的限制根据世界卫生组织给出的安全水平和建议设定。根据饮食日记计算得出的饮食处方依从性良好。低蛋白饮食对儿童的身高增长和体重增加没有任何危害。饮食组(平均每年每1.73平方米肾小球滤过率下降3.6毫升/分钟)和对照组(每年每1.73平方米2.3毫升/分钟)的肾衰竭进展都很小。当分析所有患者或各种原发性肾脏疾病的亚组时,饮食组和对照组之间的差异在统计学上不显著。当仅考虑依从性良好的患者(通过饮食日记或尿素氮排泄记录)时,也得到了相同的结果。总之,大多数患者接受了蛋白质摄入量的减少。(摘要截短为250字)