Gluba-Brzózka Anna, Franczyk Beata, Rysz Jacek
Department of Nephrology, Hypertension and Family Medicine, WAM Teaching Hospital of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
Nutrients. 2017 Apr 10;9(4):374. doi: 10.3390/nu9040374.
Healthy diet is highly important, especially in patients with chronic kidney disease (CKD). Proper nutrition provides the energy to perform everyday activities, prevents infection, builds muscle, and helps to prevent kidney disease from getting worse. However, what does a proper diet mean for a CKD patient? Nutrition requirements differ depending on the level of kidney function and the presence of co-morbid conditions, including hypertension, diabetes, and cardiovascular disease. The diet of CKD patients should help to slow the rate of progression of kidney failure, reduce uremic toxicity, decrease proteinuria, maintain good nutritional status, and lower the risk of kidney disease-related secondary complications (cardiovascular disease, bone disease, and hypertension). It has been suggested that plant proteins may exert beneficial effects on blood pressure, proteinuria, and glomerular filtration rate, as well as results in milder renal tissue damage when compared to animal proteins. The National Kidney Foundation recommends vegetarianism, or part-time vegetarian diet as being beneficial to CKD patients. Their recommendations are supported by the results of studies demonstrating that a plant-based diet may hamper the development or progression of some complications of chronic kidney disease, such as heart disease, protein loss in urine, and the progression of kidney damage. However, there are sparse reports suggesting that a vegan diet is not appropriate for CKD patients and those undergoing dialysis due to the difficulty in consuming enough protein and in maintaining proper potassium and phosphorus levels. Therefore, this review will focus on the problem as to whether vegetarian diet and its modifications are suitable for chronic kidney disease patients.
健康饮食非常重要，尤其是对于慢性肾脏病（CKD）患者。合理的营养为日常活动提供能量，预防感染，增强肌肉，并有助于防止肾脏疾病恶化。然而，对于CKD患者来说，合理饮食意味着什么呢？营养需求因肾功能水平以及是否存在合并症（包括高血压、糖尿病和心血管疾病）而有所不同。CKD患者的饮食应有助于减缓肾衰竭的进展速度，降低尿毒症毒性，减少蛋白尿，维持良好的营养状况，并降低与肾脏疾病相关的继发性并发症（心血管疾病、骨病和高血压）的风险。有人认为，与动物蛋白相比，植物蛋白可能对血压、蛋白尿和肾小球滤过率产生有益影响，并且导致的肾组织损伤较轻。美国国家肾脏基金会建议素食主义或部分时间素食对CKD患者有益。他们的建议得到了研究结果的支持，这些研究表明，以植物为基础的饮食可能会阻碍慢性肾脏病某些并发症的发展或进展，如心脏病、尿蛋白丢失和肾损伤的进展。然而，有少量报告表明，纯素饮食不适用于CKD患者和正在接受透析的患者，因为难以摄入足够的蛋白质以及维持适当的钾和磷水平。因此，本综述将聚焦于素食及其调整是否适合慢性肾脏病患者这一问题。
