Kamper Anne-Lise, Strandgaard Svend
Department of Nephrology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark; email:
Department of Nephrology, Herlev Hospital, University of Copenhagen, 2730 Copenhagen, Denmark; email:
Annu Rev Nutr. 2017 Aug 21;37:347-369. doi: 10.1146/annurev-nutr-071714-034426. Epub 2017 Jun 21.
Chronic kidney disease (CKD) has a prevalence of approximately 13% and is most frequently caused by diabetes and hypertension. In population studies, CKD etiology is often uncertain. Some experimental and observational human studies have suggested that high-protein intake may increase CKD progression and even cause CKD in healthy people. The protein source may be important. Daily red meat consumption over years may increase CKD risk, whereas white meat and dairy proteins appear to have no such effect, and fruit and vegetable proteins may be renal protective. Few randomized trials exist with an observation time greater than 6 months, and most of these were conducted in patients with preexisting diseases that dispose to CKD. Results conflict and do not allow any conclusion about kidney-damaging effects of long-term, high-protein intake. Until additional data become available, present knowledge seems to substantiate a concern. Screening for CKD should be considered before and during long-term, high-protein intake.
慢性肾脏病(CKD)的患病率约为13%,最常见的病因是糖尿病和高血压。在人群研究中,CKD的病因往往不明确。一些人体实验和观察性研究表明,高蛋白摄入可能会加速CKD的进展,甚至在健康人群中引发CKD。蛋白质来源可能很重要。多年来每日食用红肉可能会增加CKD风险,而白肉和乳制品蛋白似乎没有这种影响,水果和蔬菜蛋白可能对肾脏有保护作用。观察时间超过6个月的随机试验很少,而且其中大多数是在已有CKD易患疾病的患者中进行的。研究结果相互矛盾,无法就长期高蛋白摄入对肾脏的损害作用得出任何结论。在获得更多数据之前,现有知识似乎证实了一种担忧。在长期高蛋白摄入之前和期间,应考虑进行CKD筛查。