Department of Interdisciplinary Research, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA.
Department of Undergraduate Health Professionals, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA.
Nutrients. 2021 Sep 19;13(9):3277. doi: 10.3390/nu13093277.
Chronic kidney disease affects ~37 million adults in the US, and it is often undiagnosed due to a lack of apparent symptoms in early stages. Chronic kidney disease (CKD) interferes with the body's physiological and biological mechanisms, such as fluid electrolyte and pH balance, blood pressure regulation, excretion of toxins and waste, vitamin D metabolism, and hormonal regulation. Many CKD patients are at risk of hyperkalemia, hyperphosphatemia, chronic metabolic acidosis, bone deterioration, blood pressure abnormalities, and edema. These risks may be minimized, and the disease's progression may be slowed through careful monitoring of protein, phosphorus, potassium, sodium, and calcium, relieving symptoms experienced by CKD patients. In this review, the current Kidney Disease Outcomes Quality Initiative (KDOQI) recommendations are highlighted, reflecting the 2020 update, including explanations for the pathophysiology behind the recommendations. The Dietary Approaches to Stop Hypertension, the Mediterranean diet, and the whole foods plant-based diet are currently being examined for their potential role in delaying CKD progression. Biological explanations for why the whole foods plant-based diet may benefit CKD patients compared to diets that include animal products are examined. Strong evidence continues to support the importance of diet meeting the daily requirement in the prevention and progression of kidney disease, and medical nutrition therapy with a registered dietitian is a critical aspect in medical intervention for CKD.
慢性肾脏病影响美国约 3700 万成年人，由于早期缺乏明显症状，往往未被诊断出来。慢性肾脏病（CKD）干扰了身体的生理和生物机制，如液体电解质和 pH 值平衡、血压调节、毒素和废物排泄、维生素 D 代谢以及激素调节。许多 CKD 患者有发生高钾血症、高磷血症、慢性代谢性酸中毒、骨恶化、血压异常和水肿的风险。通过仔细监测蛋白质、磷、钾、钠和钙，可以减轻这些风险，并减缓疾病的进展，同时缓解 CKD 患者的症状。在这篇综述中，突出了当前的肾脏病预后质量倡议（KDOQI）建议，反映了 2020 年的更新，包括对建议背后的病理生理学的解释。目前正在研究高血压的饮食控制方法、地中海饮食和全食物植物性饮食在延缓 CKD 进展方面的潜在作用。还检查了为什么全食物植物性饮食可能比包含动物产品的饮食对 CKD 患者有益的生物学解释。大量证据继续支持饮食满足日常需求在预防和治疗肾脏疾病中的重要性，而注册营养师的医学营养治疗是 CKD 医学干预的关键方面。
