Department of Medicine (DIMED), Clinical Nutrition, University of Padova, 35128 Padova, Italy.
Nephrology, Dialysis and Transplantation Units, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy.
Nutrients. 2021 Aug 26;13(9):2960. doi: 10.3390/nu13092960.
Gitelman's (GS) and Bartter's (BS) syndromes are rare, inherited autosomal recessive tubulopathies characterized by hypokalemia, metabolic alkalosis, renal sodium, chloride, and potassium and magnesium-wasting. While the treatment based on potassium, sodium, chloride, and magnesium supplementation in addition to other pharmacologic options are widely established, recommendations about the dietary approach to GS and BS still remain generic. In this review we focus on the dietary strategies to increase sodium, potassium, and magnesium intake in GS and BS patients. Potassium and magnesium-rich foods and supplements are considered together with those that may reduce through different mechanisms the potassium and magnesium plasma level. Magnesium supplementation is often poorly tolerated, causing abdominal pain and diarrhea in most patients. New formulations using liposome and, in particular, sucrosomial technology have been recently proposed for magnesium supplementation in order to increase magnesium supplement tolerability and intestinal absorption. The dietary approach to GS and BS may be very important in the therapeutic approach to these syndromes. Due to the relevance of the dietary approach to these syndromes, a nutritional counseling should always be recommended and the nutritionist should join nephrologists in the follow-up of GS and BS patient care.
Gitelman 综合征(GS)和 Bartter 综合征(BS)均为罕见的遗传性常染色体隐性肾小管疾病,其特征为低钾血症、代谢性碱中毒、肾脏钠、氯、钾和镁丢失。尽管基于钾、钠、氯和镁补充的治疗以及其他药物治疗选择已广泛确立,但 GS 和 BS 的饮食方法推荐仍较为笼统。在本综述中,我们重点关注增加 GS 和 BS 患者钠、钾和镁摄入的饮食策略。钾和镁丰富的食物和补充剂与那些可能通过不同机制降低血浆钾和镁水平的食物和补充剂一起考虑。镁补充剂通常耐受性较差,会引起大多数患者腹痛和腹泻。最近提出了使用脂质体的新配方,特别是蔗糖酯技术,用于镁补充,以提高镁补充剂的耐受性和肠道吸收。GS 和 BS 的饮食方法可能在这些综合征的治疗方法中非常重要。鉴于饮食方法对这些综合征的重要性,应始终建议进行营养咨询,营养师应与肾病学家一起参与 GS 和 BS 患者的护理。