Torreggiani Massimo, Fois Antioco, Lippi Françoise, Attini Rossella, Longhitano Elisa, Matarazzo Ida, Masturzo Bianca, Cabiddu Gianfranca, Versino Elisabetta, Piccoli Giorgina Barbara
Néphrologie et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, Le Mans, France.
Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, Torino, Italy.
Clin Kidney J. 2022 Dec 9;16(4):647-661. doi: 10.1093/ckj/sfac267. eCollection 2023 Apr.
Climate change is inducing us to rethink our way of life. There is widespread awareness that we need to adopt environmentally friendly approaches and reduce the amount of waste we generate. In medicine, nephrology was one of the first specialties to adopt a green approach. Plant-based or vegan-vegetarian diets, which are planet-friendly and associated with a reduced carbon footprint, were rapidly acknowledged as a valid method for reducing protein intake in the conservative management of chronic kidney disease (CKD). However, how the transition from an omnivorous to a plant-based diet should be managed is not universally agreed; there is little data in the literature and indications based on randomized trials fail to consider feasibility and patients' preferences. Nonetheless, in some conditions the use of plant-based diets has proved safe and effective. For example, in CKD pregnancies, it has reduced unfavorable maternal and fetal outcomes. This review will present the available evidence on the benefits of plant-based diets in CKD, as well as old and new criticisms of their use, including emerging issues, such as contaminants, additives and pesticides, from a green nephrology perspective.
气候变化促使我们重新思考生活方式。人们普遍意识到，我们需要采用环保方式，减少产生的废弃物数量。在医学领域，肾脏病学是最早采用绿色方法的专科之一。对地球友好且碳足迹较小的植物性饮食或纯素-素食饮食，很快被确认为慢性肾脏病（CKD）保守治疗中减少蛋白质摄入的有效方法。然而，对于如何从杂食饮食过渡到植物性饮食，尚未达成普遍共识；文献中的数据很少，基于随机试验的指征也未考虑可行性和患者偏好。尽管如此，在某些情况下，植物性饮食已被证明是安全有效的。例如，在CKD孕妇中，它减少了不良的母婴结局。本综述将从绿色肾脏病学的角度，呈现关于植物性饮食对CKD益处的现有证据，以及对其使用的新老批评，包括污染物、添加剂和农药等新出现的问题。
