Snelson Matthew, Clarke Rachel E, Coughlan Melinda T
Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia.
Department of Physiology, Monash University, Clayton 3800, Australia.
Nutrients. 2017 Mar 11;9(3):265. doi: 10.3390/nu9030265.
Diet is one of the largest modifiable risk factors for chronic kidney disease (CKD)-related death and disability. CKD is largely a progressive disease; however, it is increasingly appreciated that hallmarks of chronic kidney disease such as albuminuria can regress over time. The factors driving albuminuria resolution remain elusive. Since albuminuria is a strong risk factor for GFR loss, modifiable lifestyle factors that lead to an improvement in albuminuria would likely reduce the burden of CKD in high-risk individuals, such as patients with diabetes. Dietary therapy such as protein and sodium restriction has historically been used in the management of CKD. Evidence is emerging to indicate that other nutrients may influence kidney health, either through metabolic or haemodynamic pathways or via the modification of gut homeostasis. This review focuses on the role of diet in the pathogenesis and progression of CKD and discusses the latest findings related to the mechanisms of diet-induced kidney disease. It is possible that optimizing diet quality or restricting dietary intake could be harnessed as an adjunct therapy for CKD prevention or progression in susceptible individuals, thereby reducing the burden of CKD.
饮食是慢性肾脏病（CKD）相关死亡和残疾的最大可改变风险因素之一。CKD在很大程度上是一种进行性疾病；然而，人们越来越认识到，诸如蛋白尿等慢性肾脏病的特征可能会随着时间的推移而消退。导致蛋白尿消退的因素仍然不明。由于蛋白尿是肾小球滤过率（GFR）下降的一个重要风险因素，因此，可改变的生活方式因素若能改善蛋白尿，可能会减轻高危个体（如糖尿病患者）的CKD负担。诸如限制蛋白质和钠摄入等饮食疗法历来用于CKD的管理。越来越多的证据表明，其他营养素可能通过代谢或血流动力学途径或通过改变肠道内环境稳态来影响肾脏健康。本综述重点关注饮食在CKD发病机制和进展中的作用，并讨论与饮食性肾病机制相关的最新研究结果。优化饮食质量或限制饮食摄入量有可能作为一种辅助疗法，用于预防或延缓易感个体的CKD进展，从而减轻CKD负担。
