Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
Department of Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807017, Taiwan.
Nutrients. 2021 Jan 30;13(2):469. doi: 10.3390/nu13020469.
Chronic kidney disease (CKD) is cumulative worldwide and an increasing public health issue. Aside from the widely known protein restriction and medical therapy, less evident is the renal protection of nutrition supplements in CKD patients. This systematic review (SR), using a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, aims to summarize and quantify evidence about the prevention effects of vitamin D and analogues, omega-3 polyunsaturated fatty acid (omega-3 PUFA), dietary fiber, coenzyme Q10 (CoQ10), and biotics on CKD progression. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to examine SRs and/or meta-analysis of clinical controlled trials identified from PubMed, Embase, and the Cochrane Library. Finally, seventeen SRs were included in the qualitative analysis. The beneficial effects of these nutrition supplements in CKD patients mostly seem to be at low to very low evidence on proteinuria, kidney function, and inflammations and did not appear to improve CKD prognosis. The recommendation of nutrition supplements in CKD patients needs to discuss with physicians and consider the benefits over the adverse effects. Longer follow-up of larger randomized trials is necessary to clarify the benefits of nutrition supplements in CKD patients.
慢性肾脏病（CKD）在全球范围内呈累积趋势，是一个日益严重的公共卫生问题。除了众所周知的蛋白质限制和医学治疗外，CKD 患者营养补充对肾脏的保护作用则不那么明显。本系统评价（SR）采用推荐评估、制定与评价（GRADE）方法，旨在总结和量化关于维生素 D 及其类似物、ω-3 多不饱和脂肪酸（ω-3 PUFA）、膳食纤维、辅酶 Q10（CoQ10）和益生菌预防 CKD 进展的证据。本研究按照系统评价和荟萃分析的首选报告项目（PRISMA）声明进行，以检查从 PubMed、Embase 和 Cochrane Library 中确定的 SR 和/或临床对照试验的荟萃分析。最后，有 17 项 SR 纳入定性分析。这些营养补充剂在 CKD 患者中的有益作用似乎主要是低到极低证据水平的蛋白尿、肾功能和炎症，并似乎不能改善 CKD 预后。在 CKD 患者中推荐使用营养补充剂需要与医生讨论，并考虑其益处是否超过不良反应。需要进行更长时间的更大规模随机试验，以阐明营养补充剂在 CKD 患者中的益处。
