U.O.C. di Nefrologia, PO "Agostino Landolfi", Via Melito snc, 83029, Solofra, AV, Italy.
Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy.
J Nephrol. 2018 Oct;31(5):635-643. doi: 10.1007/s40620-018-0470-x. Epub 2018 Jan 17.
CKD-related nutritional therapy (NT) is a crucial cornerstone of CKD patients' treatment, but the role of NT has not been clearly investigated in autosomal dominant polycystic kidney disease (ADPKD). Several clinical studies have focused on new pharmacological approaches to delay cystic disease progression, but there are no data on dietary interventions in ADPKD patients. The aim of this paper is to analyze the evidence from the literature on the impact of five nutritional aspects (water, sodium, phosphorus, protein intake, and net acid load) in CKD-related ADPKD extrapolating-where information is unavailable-from what occurs in CKD non-ADPKD patients Sodium intake restriction could be useful in decreasing the growth rate of cysts. Although further evidence is needed, restriction of phosphorus and protein intake restriction represent cornerstones of the dietary support of renal non-ADPKD patients and common sense can guide their use. It could be also helpful to limit animal protein, increasing fruit and vegetables intake together with a full correction of metabolic acidosis. Finally, fluid intake may be recommended in the early stages of the disease, although it is not to be prescribed in the presence of moderate to severe reduction of renal function.
与慢性肾脏病相关的营养治疗（NT）是慢性肾脏病患者治疗的重要基石，但 NT 在常染色体显性多囊肾病（ADPKD）中的作用尚未得到明确研究。一些临床研究侧重于新的药理学方法来延缓囊性疾病的进展，但在 ADPKD 患者中没有关于饮食干预的数据。本文的目的是分析文献中关于五个营养方面（水、钠、磷、蛋白质摄入和净酸负荷）对与慢性肾脏病相关的 ADPKD 的影响的证据，在没有信息的情况下，从非 ADPKD 慢性肾脏病患者的情况进行推断。限制钠的摄入可能有助于减少囊肿的生长速度。尽管需要进一步的证据，但限制磷和蛋白质的摄入仍然是肾脏非 ADPKD 患者饮食支持的基石，常识可以指导其使用。限制动物蛋白，增加水果和蔬菜的摄入，同时充分纠正代谢性酸中毒也可能有帮助。最后，在疾病的早期阶段可能建议摄入液体，但在存在中度至重度肾功能减退的情况下不应规定摄入液体。
