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[糖尿病肾病患者饮食支持的现代方法]

[Modern approaches to dietary support for patients with diabetic nephropathy].

作者信息

Sharafetdinov Kh Kh, Shekhetov A A, Plotnikova O A

机构信息

Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow.

Russian Medical Academy of Continuing Professional Education, Moscow.

出版信息

Vopr Pitan. 2018;87(6):6-15. doi: 10.24411/0042-8833-2018-10061. Epub 2018 Nov 13.

Abstract

The article presents modern approaches to dietary support of patients with diabetic nephropathy (DN) characterized by gradual sclerosis of the renal tissue, leading to a loss of filtration and nitrogen excretory function of the kidneys. An analysis of publications of domestic and foreign authors indicates a slowdown in the progression of chronic kidney disease against the background of low-protein diets. However, the role of protein restriction and its qualitative composition in the diet of patients with DN is the subject of comprehensive discussion. KDOQI (2007) Clinical Practice Guidelines and Clinical Practice Guidelines for Kidney Disease determine the target level of protein intake in individuals with diabetes and chronic kidney disease 1-4 stages at the level of 0.8 g/kg of body weight per day. In the recommendations on nutrition for patients with DN, along with a controlled reduction in protein content, great importance is attached to reducing sodium intake from food to 1.5-2.3 g per day. In recent years, close attention has been paid to the use of highly active natural antioxidants for the treatment and prevention of type 2 diabetes, including DN, which was determined by the results of studies demonstrating their beneficial effects on DN patterns. It has been shown that one of the ways to optimize the nutrition of patients with DN is the use of specialized foods modified by protein, fat and carbohydrate composition, including food ingredients with hypoglycemic, hypolipidemic and antioxidant effects.

摘要

本文介绍了糖尿病肾病(DN)患者饮食支持的现代方法,其特征为肾组织逐渐硬化,导致肾脏滤过和氮排泄功能丧失。对国内外作者发表的文献分析表明,在低蛋白饮食的背景下,慢性肾病的进展有所减缓。然而,蛋白质限制及其在DN患者饮食中的质量组成的作用是全面讨论的主题。KDOQI(2007)临床实践指南和肾脏病临床实践指南确定糖尿病和1-4期慢性肾病患者的蛋白质摄入目标水平为每天0.8克/千克体重。在DN患者的营养建议中,除了控制蛋白质含量的降低外,还非常重视将食物中的钠摄入量减少到每天1.5-2.3克。近年来,高活性天然抗氧化剂在2型糖尿病(包括DN)的治疗和预防中的应用受到密切关注,这是由研究结果决定的,这些研究表明它们对DN模式有有益影响。研究表明,优化DN患者营养的方法之一是使用经过蛋白质、脂肪和碳水化合物成分改良的特殊食品,包括具有降血糖、降血脂和抗氧化作用的食品成分。

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