Druml W, Mitch W E
Harvard Medical School, Boston, Mass.
Blood Purif. 1988;6(5):285-98. doi: 10.1159/000169556.
Interest in dietary therapy of chronic uremia has reawakened because such therapy may slow or halt progression of renal insufficiency. The efficacies of three regimens: 0.6 g protein/kg/day; 0.3 g protein/kg/day plus essential amino acids, and 0.3 g protein/kg/day plus keto acid regimens, have been tested. Each can maintain nitrogen balance if properly administered but if dietary protein and/or the supplement are inadequate, muscle wasting will occur. Data showing that each can slow the rise in serum creatinine are presented. The problems with using serum creatinine, potential mechanisms for the effect on progression and methods for monitoring compliance are discussed.
对慢性尿毒症饮食疗法的兴趣再度兴起，因为这种疗法可能减缓或阻止肾功能不全的进展。已经测试了三种方案的疗效：每天每千克体重0.6克蛋白质；每天每千克体重0.3克蛋白质加必需氨基酸，以及每天每千克体重0.3克蛋白质加酮酸方案。如果合理施用，每种方案都能维持氮平衡，但如果膳食蛋白质和/或补充剂不足，就会出现肌肉消瘦。文中给出了表明每种方案都能减缓血清肌酐升高的数据。讨论了使用血清肌酐存在的问题、对疾病进展产生影响的潜在机制以及监测依从性的方法。
