Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
J Ren Nutr. 2019 Mar;29(2):112-117. doi: 10.1053/j.jrn.2018.06.006. Epub 2018 Aug 16.
Concerns regarding protein and amino acid deficiencies with plant-based proteins have precluded their use in chronic kidney disease (CKD) patients. Many of these concerns were debunked years ago, but recommendations persist regarding the use of "high-biological value" (animal-based) proteins in CKD patients, which may contribute to worsening of other parameters such as blood pressure, metabolic acidosis, and hyperphosphatemia. Plant-based proteins are sufficient in meeting both quantity and quality requirements. Those eating primarily plant-based diets have been observed to consume approximately 1.0 g/kg/day of protein, or more. CKD patients have been seen to consume 0.7-0.9 g/kg/day of mostly plant-based protein without any negative effects. Furthermore, those substituting animal-based proteins for plant-based proteins have shown reductions in severity of hypertension, hyperphosphatemia, and metabolic acidosis. Plant-based proteins, when consumed in a varied diet, are not only nutritionally adequate but have pleiotropic effects which may favor their use in CKD patients.
人们对植物蛋白可能导致蛋白质和氨基酸缺乏的担忧,一直阻碍着其在慢性肾脏病(CKD)患者中的应用。这些担忧中的许多在多年前就已被揭穿,但目前仍有关于在 CKD 患者中使用“高生物价值”(动物源)蛋白的建议,这可能导致其他参数恶化,如血压、代谢性酸中毒和高磷血症。植物蛋白完全能够满足数量和质量的需求。以植物性食物为主的人,其蛋白质摄入量约为 1.0g/kg/天,甚至更多。观察到 CKD 患者的植物性蛋白摄入量为 0.7-0.9g/kg/天,也没有任何负面影响。此外,用植物性蛋白替代动物性蛋白的患者,其高血压、高磷血症和代谢性酸中毒的严重程度有所降低。当以多样化饮食摄入植物蛋白时,不仅营养充足,而且具有多种有益作用,这可能有利于将其用于 CKD 患者。