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植物性、动物性或混合性饮食:慢性肾脏病患者该如何选择?

Plant or Animal-Based or PLADO Diets: Which Should Chronic Kidney Disease Patients Choose?

机构信息

Department of Nephrology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Clinical Nutrition, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

出版信息

J Ren Nutr. 2023 Mar;33(2):228-235. doi: 10.1053/j.jrn.2022.06.011. Epub 2022 Jul 6.

Abstract

Nutrition therapy is the cornerstone treatment for chronic kidney disease (CKD). Although much attention has been given to dietary protein intake in CKD patients, many findings now demonstrate that the type of dietary protein intake may be more critical for CKD patients. In protein bioavailability and malnutrition prevention, many physicians recommend that CKD patients adhere to a low protein diet and restrict their plant foods, such as vegetables, fruits, and soybeans. However, nephrologists should not ignore the potential benefits of plant foods for CKD patients. It is not advisable to restrict the intake of plant foods in the later stage of CKD simply to prevent the development of hyperkalemia and malnutrition. This article highlights the benefits and possible problems of a plant-dominant low protein diet (PLADO) diet, defined as an LPD with dietary protein intake of 0.6-0.8 g/kg/day with at least 50% plant-based source for CKD patients. We hope to provide new opinions for clinical work and CKD patients.

摘要

营养治疗是慢性肾脏病(CKD)的基石治疗方法。尽管人们对 CKD 患者的膳食蛋白质摄入量给予了极大关注,但许多研究结果表明,膳食蛋白质的类型对 CKD 患者可能更为关键。在蛋白质生物利用度和营养不良预防方面,许多医生建议 CKD 患者遵循低蛋白饮食,限制植物性食物的摄入,如蔬菜、水果和大豆。然而,肾脏病医生不应忽视植物性食物对 CKD 患者的潜在益处。在 CKD 后期,为了单纯预防高钾血症和营养不良而限制植物性食物的摄入是不可取的。本文强调了植物主导的低蛋白饮食(PLADO)对 CKD 患者的益处和可能存在的问题,PLADO 定义为 CKD 患者的低蛋白饮食,其蛋白质摄入量为 0.6-0.8 g/kg/天,且至少 50%来源于植物。我们希望为临床工作和 CKD 患者提供新的观点。

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