St-Jules David E, Goldfarb David S, Popp Collin J, Pompeii Mary Lou, Liebman Scott E
Division of Health and Behavior, Department of Population Health, New York University School of Medicine, New York, NY, USA.
Division of Nephrology, Department of Medicine, New York University School of Medicine, New York, NY, USA.
Semin Dial. 2019 Jan;32(1):41-46. doi: 10.1111/sdi.12737. Epub 2018 Jul 15.
Protein-energy wasting (PEW) is a major diet-related complication in hemodialysis (HD) patients. Nutrient-based dietary guidelines emphasize animal-based protein foods for preventing and managing PEW in HD patients. Although dietary protein intake is important for protein anabolism, other dietary factors contribute to PEW. In this article, we examine the diet-related etiologies of PEW in HD patients, and discuss how they may be affected differently by animal- and plant-based protein foods. In general, animal foods are superior sources of protein, but may contribute more to metabolic derangements that cause PEW. Given the potential mixed effects of animal-based protein foods on PEW, human research studies are needed to determine the impact of liberalizing the diet to allow plant-based protein foods on protein status.
蛋白质-能量消耗（PEW）是血液透析（HD）患者主要的饮食相关并发症。基于营养素的饮食指南强调动物性蛋白质食物对HD患者预防和管理PEW的作用。尽管饮食蛋白质摄入对蛋白质合成代谢很重要，但其他饮食因素也会导致PEW。在本文中，我们研究了HD患者中与饮食相关的PEW病因，并讨论了动物性和植物性蛋白质食物对它们的不同影响。一般来说，动物性食物是优质蛋白质来源，但可能对导致PEW的代谢紊乱贡献更大。鉴于动物性蛋白质食物对PEW可能存在的混合影响，需要开展人体研究以确定放宽饮食以纳入植物性蛋白质食物对蛋白质状态的影响。
