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4
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低蛋白饮食对保守治疗的慢性肾脏病患者血脂及人体测量指标的影响。

Effects of Low-Protein Diet on lipid and anthropometric profiles of patients with chronic kidney disease on conservative management.

作者信息

Fontes Bruna Carvalho, Anjos Juliana Saraiva Dos, Black Ana Paula, Moreira Nara Xavier, Mafra Denise

机构信息

Universidade Federal Fluminense, Programa de Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ, Brasil.

Universidade Federal Fluminense, Programa de Pós-Graduação em Ciências Médicas, Niterói, RJ, Brasil.

出版信息

J Bras Nefrol. 2018 Jul-Sep;40(3):225-232. doi: 10.1590/2175-8239-jbn-3842. Epub 2018 Jun 25.

DOI:10.1590/2175-8239-jbn-3842
PMID:29944154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6533945/
Abstract

INTRODUCTION

Chronic Kidney disease (CKD) patients have a high prevalence of cardiovascular mortality, and among the risk factors are dyslipidemia and obesity, common findings in the early stages of CKD. The aim of this study was to evaluate the effects of low protein diet (LPD) on the lipid and anthropometric profile in non-dialysis CKD patients.

METHODS

Forty CKD patients were studied (20 men, 62.7 ± 15.2 years, glomerular filtration rate (GFR) 26.16 ± 9.4 mL/min/1.73m2). LPD (0.6g/kg/d) was prescribed for six months and, biochemical and anthropometric parameters like body mass index (BMI), waist circumference and body fat mass (assessed by dual X-ray absorptiometry - DXA) were evaluated before and after six months with LPD.

RESULTS

After six months of nutritional intervention, patients presented reduction on BMI (from 28.1 ± 5.6 to 27.0 ± 5.3 Kg/m2, p = 0.001), total cholesterol (from 199.7 ± 57.1 to 176.0 ± 43.6mg/dL, p = 0.0001), LDL (from 116.2 ± 48.1 to 97.4 ± 39.1 mg/dL, p = 0,001) and uric acid (from 6.8 ± 1.4 to 6.2 ± 1.3 mg/dL, p = 0.004). In addition, GFR values were increased from 26.2 ± 9.5 to 28.9 ± 12.7mL/min (p = 0.02). The energy, proteins, cholesterol and fiber intake were reduced significantly.

CONCLUSION

LPD prescribe to non-dialysis CKD patients for six months was able to improve some cardiovascular risk factors as overweight and plasma lipid profile, suggesting that LPD can be also an important tool for protection against cardiovascular diseases in these patients.

摘要

引言

慢性肾脏病(CKD)患者心血管疾病死亡率很高,其中血脂异常和肥胖是CKD早期常见的危险因素。本研究旨在评估低蛋白饮食(LPD)对非透析CKD患者血脂和人体测量指标的影响。

方法

对40例CKD患者进行研究(20名男性,年龄62.7±15.2岁,肾小球滤过率(GFR)26.16±9.4mL/min/1.73m²)。给予LPD(0.6g/kg/d)为期6个月,并在LPD治疗6个月前后评估体重指数(BMI)、腰围和体脂肪量(通过双能X线吸收法-DXA评估)等生化和人体测量参数。

结果

经过6个月的营养干预,患者的BMI降低(从28.1±5.6降至27.0±5.3Kg/m²,p = 0.001),总胆固醇(从199.7±57.1降至176.0±43.6mg/dL,p = 0.0001),低密度脂蛋白(从116.2±48.1降至97.4±39.1mg/dL,p = 0.001)和尿酸(从6.8±1.4降至6.2±1.3mg/dL,p = 0.004)。此外,GFR值从26.2±9.5提高到28.9±12.7mL/min(p = 0.02)。能量、蛋白质、胆固醇和纤维摄入量显著降低。

结论

对非透析CKD患者给予LPD治疗6个月能够改善一些心血管危险因素,如超重和血脂谱,提示LPD也可能是这些患者预防心血管疾病的重要手段。